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Perceived stress in myocardial infarction with non-obstructive coronary arteries?
Session:
Posters (Sessão 3 - Écran 2) - Enfarte Agudo do Miocárdio 2
Speaker:
Margarida G. Figueiredo
Congress:
CPC 2023
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:
Pósters Electrónicos
FP Number:
---
Authors:
Margarida G. Figueiredo; Sofia B. Paula; Mariana Santos; Hélder Santos; Mariana Coelho; Samuel Almeida; Lurdes Almeida
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Introduction: The acronym MINOCA (myocardial infarction with non-obstructive coronary arteries) defines a condition of acute coronary syndrome (ACS) with no angiographic obstructive coronary artery disease (CAD). A relationship between MINOCA and stress has already been described, since intense emotions can trigger this condition. The 10-item Perceived Stress Scale (PSS-10) is a validated instrument to estimate stress levels in clinical practice. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Objective: To evaluate if stress was a predictor of MINOCA in patients hospitalized for ACS.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods: We carried out a single-center prospective study involving patients hospitalized for</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">ACS between March 20, 2019 and March 3, 2020. The PSS-10 was completed during the hospitalization period. Patients were divided into two groups, according to CAD: group A with CAD and group B with MINOCA. Follow-up of these patients was carried out until December 11, 2022, regarding death, readmissions for cardiac causes and readmissions for other causes. Logistic regression was performed to assess if stress was a predictor of MINOCA.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results: A total of 166 patients with ACS were included, of whom 107 in group A and 35 in group B. In group A, mean age was 63.4 ± 13.2 years and 32.1% were women, while in group B mean age was 66.4 ± 11.4 years, and 45.7% were female. There were no statistically significant differences between the two groups regarding cardiovascular risk factors. Group A presented more with chest pain (86.9% vs 62.9%, p=0.002); there were no other statistically significant variables at presentation or regarding intrahospital complications between the two groups. In group A, PSS-10 score was 18.8 ± 7.46, while group B scored 21.6 ± 6.08 (p=0.045). The follow-up of these two groups did not show significant differences in terms of death (15.0% in group A vs 14.3% in group B, p=0.923), readmissions for cardiac causes (group A - 17.8% vs group B - 17.1%, p=0.934) or readmissions for other causes (29.0% in group A vs 20.0% in group B, p=0.298). Logistic regression revealed that stress was a predictor of MINOCA (odds ratio (OR) 1.006, p=0.048, confidence interval (CI) 1.000-1.011).</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusions: Perceived stress is a predictor of MINOCA, while MINOCA does not predict mortality, neither readmission for cardiac or other causes. To our knowledge, this is the first Portuguese prospective study to assess the relationship between stress and MINOCA.</span></span></p>
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