Archives of the Turkish Society of Cardiology
Comparison of psychosocial risk factors between patients who experience acute myocardial infarction before and after 40 years of age [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2011; 39(5): 396-402 | DOI: 10.5543/tkda.2011.01412

Comparison of psychosocial risk factors between patients who experience acute myocardial infarction before and after 40 years of age

Cihan Şengül, Olcay Özveren, Cihan Çevik, Cemil İzgi, Yusuf Karavelioğlu, Vecih Oduncu, Taylan Akgün, Mehmet Mustafa Can, Nihal Özdemir, Mehmet Özkan
Kartal Kosuyolu Heart Education And Research Hospital, Department Of Cardiology, İstanbul, Turkey


OBJECTIVES
Several studies have shown that psychosocial risk factors such as stress and depression make substantial contribution to the pathogenesis of coronary artery disease. This study aimed to investigate acute stress factors prior to acute myocardial infarction (AMI), and stress, depression, and anxiety levels during the subacute period in AMI patients aged ≤40 years, in comparison with AMI patients aged >40 years.

STUDY DESIGN
The study included 200 first-time AMI patients aged ≤40 years (n=100; mean age 35±4 years) and >40 years (n=100; mean age 54±9 years). The DASS 21 scale (Depression Anxiety Stress Scales) was administered via face-to-face interviews in the early recovery period of AMI. The patients were also questioned whether they had experienced acute stress factors such as severe emotional or physical stressful events within two hours before the onset of chest pain. In addition, coronary angiography results were assessed based on the two age groups.

RESULTS
Comparison of the two age groups showed significantly higher frequencies of family history of CAD and smoking in the younger group, and significantly higher frequencies of hypertension, diabetes mellitus, and dyslipidemia in the older group (p<0.05). History of acute stress factors was significantly more common (52% vs. 20%, p<0.01) and stress, depression, and anxiety scores of the DASS 21 scale were all significantly higher in the younger group (p<0.01). On coronary angiography, younger patients predominantly had normal coronary arteries and single-vessel disease, whereas multi-vessel disease was more prevalent in the older age group (p<0.01).

CONCLUSION
Triggers of acute stress and psychosocial risk factors may contribute to the occurrence of AMI in individuals younger than 40 years.

Keywords: Age factors, anxiety/complications, depression/complications; myocardial infarction/psychology; psychiatric status rating scales; risk factors; stress, psychological/complications

How to cite this article
Cihan Şengül, Olcay Özveren, Cihan Çevik, Cemil İzgi, Yusuf Karavelioğlu, Vecih Oduncu, Taylan Akgün, Mehmet Mustafa Can, Nihal Özdemir, Mehmet Özkan. Comparison of psychosocial risk factors between patients who experience acute myocardial infarction before and after 40 years of age. Turk Kardiyol Dern Ars. 2011; 39(5): 396-402

Corresponding Author: Cihan Şengül, Türkiye
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