Psychological stress as precipitating factor of the acute manifestations of ischemic cardiopathy

Psychological stress may play an important role as a risk factor for coronary heart disease (CHD). Psychological stress consists of different components whose diverse role in the onset of the acute manifestations of CHD is still not clear. We studied 80 patients with acute CHD (56 with unheralded myocardial infarction, 24 with unstable angina, mean age 55 +/- 9 years, 55 men) vs 80 controls (mean age 50 +/- 9 years, 52 men) admitted for an acute traumatic event. We proposed to both groups these questionnaires: a retrospective self and etero-evaluation of the degree of psychological stress; the modified Maastricht questionnaire (MMQ) that evaluates psychic and physical manifestations of psychological stress in the period preceding admission; the social support questionnaire (SSQ); the life event assessment that evaluates frequency and importance of life events in the year preceding admission. Psychological stress index was greater in patients (self-evaluation = 7.1 +/- 2.4; etero-evaluation = 7.4 +/- 2.3; MMQ = 91 +/- 30.8) than controls (self-evaluation = 4.3 +/- 2.3; etero-evaluation = 4.3 +/- 2.4; MMQ = 58.6 +/- 32.5; p < 0.001 for all questionnaires). The perception of strong social isolation was greater in patients (SSQ = 29.8 +/- 11.8) than controls (SSQ = 23.8 +/- 9.6; p < 0.001). Painful life events were more numerous in patients (10.7 +/- 2.3) than controls (8.2 +/- 3.4; p < 0.05) and perceived in a more negative way (patients = 12.7 +/- 4.1 vs controls = 10.2 +/- 3.8; p < 0.01)