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Acute coronary syndrome and stress: is there a relationship?
Session:
Painel 8 - Doença Coronária 12
Speaker:
Hélder Santos
Congress:
CPC 2020
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.7 Acute Coronary Syndromes - Other
Session Type:
Posters
FP Number:
---
Authors:
Helder Santos; Inês Grácio De Almeida; Hugo Miranda; Mariana Da Silva Santos; Catarina Sá; Joana Chan Chin; Samuel Almeida; Catarina Santos De Sousa; Luís Santos; Lurdes Almeida; João Tavares
Abstract
<p><strong>Introduction:</strong> Acute Coronary syndrome (ACS) is a result of a complex physiological process with several dynamic factors that can influence its manifestation. Some authors advocate that stress can be a critical risk factor in ACS. The Perceived Stress Scale (PSS-10) is one of the best instruments to estimate stress in clinical practice.</p> <p><strong>Objective:</strong> Evaluate the perceived stress levels in patients admitted for ACS.</p> <p><strong>Methods</strong>: Single-centre prospective study, engaging patients hospitalized with ACS between 20/03/2019-15/12/2019. All patients completed the PSS-10 during its hospitalization period. PSS-10 was validated in the Portuguese population by Trigo<em>, et al</em>, with 10 questions and 5 possible answers (figure 1) in which each question was punctuated between 0 and 4 (maximum 40 points), allowing us to estimate the level of stress in context of physical disease. The pathological stress level was established in the Portuguese population as >20 points in males and >22 points in females. Frailty was defined as a presence of at least 5 of the follow comorbidities: smoker, arterial hypertension, diabetes, dyslipidemia, ischemic cardiomyopathy, valvopathy, stroke, heart failure, chronical kidney disease, peripheral artery disease, dementia, neoplasia and chronic obstructive pulmonary disease. T-student tests were used to compare categorical and continuous variables between groups and the Portuguese population. Linear regression was used to establish the relation between the frailty and the stress levels.</p> <p><strong>Results</strong>: 128 patients with ACS were included, 27.35% presented ST-Elevation Myocardial Infarction (STEMI), 38.28% of the ACS were female, mean age 64.51 ± 12.78 years and a medium PSS punctuation of 20.02 ± 6.81. According with Trigo<em>, et al</em>, female Portuguese population presented a medium 13.6 ± 6.3 points and females with previous history of ACS had 20.8 ± 9.8 points. On the other hand, male Portuguese population presented a medium 16.6 ± 6.3 points and males with previous history of ACS had 13.4 ± 7.9 points. Our female population with ACS presented 23.26 ± 6.28 points on the PSS-10 punctuation, revealing significant differences compared to stable coronary disease and the general population. As well as ACS male with 17.81 ± 6.27 points, <em>p</em><0.001, compared to general and stable coronary disease population. Both genders had significant differences in the ACS, <em>p</em><0.001. Regarding STEMI patients had 18.72 ± 8.50 points while non-STEMI patients presented 20.93 ± 6.12 points, <em>p</em>=0.128. ACS frail patients had 20.59 ± 6.48 points compared to non-frail 20.93 ± 6.12 points, <em>p</em>=0.816, nevertheless higher stress levels compared to the general population,<em> p</em><0.001. Frailty was a predictor of higher stress levels in ACS patients (R<sup>2</sup> 0.63), <em>p</em>=0.004.</p> <p><strong>Conclusions:</strong> ACS presented higher stress levels on PSS-10, suggesting a relationship between stress levels and ACS manifestation. Frailty was higher PPS-10 punctuation.</p>
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