The purpose of this study is to look at the link between emotional stress and heart disease in men and women. Taking part in this study involves one clinic visit, one week of at home monitoring, and follow up phone calls every 6 months for 3 years.
In the U.S. and globally, coronary heart disease (CHD) is the number one killer of women. Despite scientific advances, it is unclear whether the pathophysiology of CHD differs between women and men. The study of CHD in women has historically been centered on older women; however, women with early-onset CHD are informative for the study of early risk factors and pathophysiology. Furthermore, young women with a myocardial infarction (MI) have emerged as a group in need of special study, as this group has higher mortality compared with men of similar age despite less severe disease. These disparities remain unexplained and suggest sex differences in the pathophysiology, risk factors, and prognostic factors of acute MI. The psychosocial sphere is a largely neglected area for CHD prevention in women. Social and emotional exposures, mostly beginning early in life (depression, early life adversities, poverty, and posttraumatic stress symptoms), are more common in younger women with MI compared with men and community controls. In addition to being more prevalent, emotional stress may be a stronger risk factor in young women than in other groups. A significant challenge, however, is to measure stress validly. Building on previous work, the current project will clarify sex differences in pathways of risk linking emotional stress to mental stress-induced myocardial ischemia (MSI) and cardiovascular outcomes in young post-MI patients. Within 8 months of MI, 310 patients ≤60 years of age (at the time of the MI), 50% women, will be tested in the lab with a stress challenge to assess MSI using an established protocol with myocardial perfusion imaging. Participants will be monitored at home for 1 week and then followed for clinical events for 3 years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
306
The stress challenge assessed how different parts of the body react to stress. Participants were given no specific details about the test content before administration.
Emory University Hospital
Atlanta, Georgia, United States
Grady Health System
Atlanta, Georgia, United States
The Emory Clinic
Atlanta, Georgia, United States
Cardiovascular Events
The main outcome was a composite endpoint of recurrent MI, unstable angina, hospitalization for decompensated heart failure, and cardiovascular (CV) death. A mental stress-induced myocardial ischemia (MSI) status of positive or negative was used as the main predictor in regression models.
Time frame: 3 Years
Myocardial Infarction or Cardiovascular Death
The number of participants experiencing myocardial infarction or CV death in relation to MSI status (positive or negative).
Time frame: 3 Years
Cardiovascular Death
The number of participants with a CV death in relation to MSI status (positive or negative).
Time frame: 3 Years
Total Mortality
All-cause death in relation to MSI status (positive or negative).
Time frame: 3 Years
Cardiovascular Events Excluding Heart Failure
This is a composite endpoint of recurrent MI, unstable angina, or CV death, where the number of participants experiencing this endpoint in relation to MSI status (positive or negative) was examined.
Time frame: 3 Years
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