Dataset Information

Peripheral Vasoconstriction During Mental Stress and Adverse Cardiovascular Outcomes in Patients With Coronary Artery Disease.

ABSTRACT:

Rationale

Excessive vasoconstriction in response to mental stress may be a potential mechanism by which acute psychological stress leads to adverse cardiac events.

Objectives

We investigated whether excessive digital vasoconstriction during acute mental stress predicts adverse cardiovascular outcomes among patients with coronary artery disease.

Methods and results

Five hundred forty-nine patients with stable coronary artery disease (age 63±9, 76% male, 29% black) underwent mental stress testing with a standardized public speaking stressor and followed prospectively for cardiovascular end points. Digital pulse wave amplitude was continuously measured using peripheral artery tonometry (PAT, Itamar Inc). Stress/rest PAT ratio (sPAT) of pulse wave amplitude during mental stress/baseline was calculated and dichotomized by the median value into low and high sPAT ratio groups. Upon 3-year follow-up, Fine and Gray's subdistribution hazard ratios were used to examine the association between sPAT ratio and the composite end point of cardiovascular death, myocardial infarction, revascularization, and hospitalization for heart failure. The median sPAT ratio was 0.68 (interquartile range, 0.48-0.88), indicating 32% vasoconstriction with mental stress. Men were more likely to have low sPAT ratio than women (odds ratio, 1.79; P=0.007) while those on β-blockers were less likely to have low sPAT ratio (odds ratio, 0.52; P=0.003). After adjusting for demographic and cardiovascular risk factors, medications, and rate-pressure product change during mental stress, those with low sPAT ratio were at significantly higher risk of adverse outcomes (subdistribution hazard ratio, 1.77 [95% CI, 1.12-2.80]).

Conclusions

Greater peripheral vasoconstriction with mental stress, denoted by a low sPAT ratio, is associated with a higher risk of adverse cardiovascular outcomes in patients with coronary artery disease.

SUBMITTER: Kim JH

PROVIDER: S-EPMC7134565 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Publications

Peripheral Vasoconstriction During Mental Stress and Adverse Cardiovascular Outcomes in Patients With Coronary Artery Disease.

Kim Jeong Hwan JH Almuwaqqat Zakaria Z Hammadah Muhammad M Liu Chang C Ko Yi-An YA Lima Bruno B Sullivan Samaah S Alkhoder Ayman A Abdulbaki Rami R Ward Laura L Bremner J Douglas JD Sheps David S DS Raggi Paolo P Sun Yan V YV Shah Amit J AJ Vaccarino Viola V Quyyumi Arshed A AA

Circulation research 20190925 10

<h4>Rationale</h4>Excessive vasoconstriction in response to mental stress may be a potential mechanism by which acute psychological stress leads to adverse cardiac events.<h4>Objectives</h4>We investigated whether excessive digital vasoconstriction during acute mental stress predicts adverse cardiovascular outcomes among patients with coronary artery disease.<h4>Methods and results</h4>Five hundred forty-nine patients with stable coronary artery disease (age 63±9, 76% male, 29% black) underwent ...[more]

PMID: 31550998

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Dataset Information

Peripheral Vasoconstriction During Mental Stress and Adverse Cardiovascular Outcomes in Patients With Coronary Artery Disease.

Rationale

Objectives

Methods and results

Conclusions

Publications

Peripheral Vasoconstriction During Mental Stress and Adverse Cardiovascular Outcomes in Patients With Coronary Artery Disease.

Similar Datasets

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