Perceived stress level is associated with coronary artery disease severity in patients with ST-segment elevation myocardial infarction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2020; 48(5): 494-503 | DOI: 10.5543/tkda.2020.30020

Perceived stress level is associated with coronary artery disease severity in patients with ST-segment elevation myocardial infarction

Serkan Kahraman1, Fatma Cam Kahraman2, Hicaz Zencirkiran Agus1, Ali Kemal Kalkan1, Fatih Uzun1, Muammer Karakayalı1, Mehmet Altunova1, Samet Sevinç1, Ali Rıza Demir1, Emre Yılmaz1, Mehmet Ertürk1
1Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey
2Department of Psychology, Istanbul Kent University, Faculty of Humanities and Social Sciences, Istanbul, Turkey


OBJECTIVE
Stress is known to be a significant risk factor for coronary atherosclerosis and adverse cardiovascular events; however, the stress-related coronary atherosclerotic burden has not yet been investigated. The aim of this study was to investigate the relationship between the Perceived Stress Scale (PSS) and the SYNTAX scores in patients with ST-segment elevation myocardial infarction (STEMI).

METHODS
A total of 440 patients with STEMI were prospectively enrolled and divided into 2 groups according to the PSS score with a ROC curve analysis cut-off value of 17.5. In all, 361 patients with a low PSS score were categorized as Group 1 and 79 patients with a high PSS score were categorized as Group 2.

RESULTS
The SYNTAX score [Group 1, 16.0 (10.0–22.5); Group 2, 22.5 (15.0–25.5); p<0.001] and the SYNTAX score II were significantly higher in Group 2 [Group 1, 24.8 (19.0–32.6); Group 2, 30.9 (22.3–38.9); p<0.001]. Spearman analysis demonstrated that the PSS score was associated with the SYNTAX score (r=0.153; p=0.001) and the SYNTAX score II (r=0.216; p<0.001). Additionally, the PSS (odds ratio: 2.434, confidence interval: 1.446-4.096; p=0.001) was determined to be an independent predictor of a moderate-to-high SYNTAX score. The PSS score of patients with in-hospital mortality was also higher than those who survived [15 (10–20); 9 (4–16), respectively; p=0.007].

CONCLUSION
Stress appears to accelerate the coronary atherosclerotic process and the associated burden. An increased stress level was found to be an independent predictor of a high SYNTAX score.

Keywords: Coronary artery disease, perceived stress scale; ST-segment elevation myocardial infarction; SYNTAX score.

How to cite this article
Serkan Kahraman, Fatma Cam Kahraman, Hicaz Zencirkiran Agus, Ali Kemal Kalkan, Fatih Uzun, Muammer Karakayalı, Mehmet Altunova, Samet Sevinç, Ali Rıza Demir, Emre Yılmaz, Mehmet Ertürk. Perceived stress level is associated with coronary artery disease severity in patients with ST-segment elevation myocardial infarction. Turk Kardiyol Dern Ars. 2020; 48(5): 494-503

Corresponding Author: Serkan Kahraman, Türkiye
© Copyright 2020 Archives of the Turkish Society of Cardiology
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