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Behavior in a stressful situation, personality factors, and disease severity in patients with acute myocardial infarction: baseline findings from the prospective cohort study SECAMI (The Secondary Prevention and Compliance following Acute Myocardial Infarction-study)
Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden; Department of Neurology, Skåne University Hospital, Malmö, Sweden.
Department of Cardiology, Lund University, Skåne University Hospital, Malmö, Sweden.
Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
Department of Cardiology, Lund University, Skåne University Hospital, Malmö, Sweden.
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2011 (English)In: BMC Cardiovascular Disorders, E-ISSN 1471-2261, Vol. 11, no 45Article in journal (Refereed) Published
Abstract [en]

Background Psychosocial stress has been identified as a risk factor in association with cardiovascular disease but less attention has been paid to heterogeneity in vulnerability to stress. The serial Color Word Test (CWT) measures adaptation to a stressful situation and it can be used to identify individuals that are vulnerable to stress. Prospective studies have shown that individuals with a maladaptive behavior in this test are exposed to an increased risk of future cardiovascular events. The aim of the present study was to investigate whether maladaptive behavior in the serial CWT alone or in combination with any specific personality dimension was associated with severity of myocardial infarction (MI).Methods MI-patients (n = 147) completed the test and filled in a personality questionnaire in close proximity to the acute event. The results were analyzed in association with four indicators of severity: maximum levels above median of the cardiac biomarkers troponin I and creatine kinase-MB (CKMB), Q-wave infarctions, and a left ventricular ejection fraction (LVEF) ≤ 50%.Results Maladaptive behavior in the serial CWT together with low scores on extraversion were associated with maximum levels above median of cardiac troponin I (OR 2.97, CI 1.08-8.20, p = 0.04) and CKMB (OR 3.33, CI 1.12-9.93, p = 0.03). No associations were found between the combination maladaptive behavior and low scores on extraversion and Q-wave infarctions or a decreased LVEF. Conclusions Maladaptive behavior in combination with low scores on extraversion is associated with higher cardiac biomarker levels following an MI. The serial CWT and personality questionnaires could be used to identify individuals vulnerable to the hazardous effects of stress and thereby are exposed to an increased risk of a more severe infarction.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2011. Vol. 11, no 45
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mau:diva-4856DOI: 10.1186/1471-2261-11-45ISI: 000294287600001PubMedID: 21777467Scopus ID: 2-s2.0-79960564675Local ID: 12384OAI: oai:DiVA.org:mau-4856DiVA, id: diva2:1401690
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-12-01Bibliographically approved
In thesis
1. Myocardial infarction personality factors, coping strategies, depression and secondary prevention
Open this publication in new window or tab >>Myocardial infarction personality factors, coping strategies, depression and secondary prevention
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A longitudinal study with 400 patients diagnosed with myocardial infarction (MI) was conducted at the Cardiology department at Malmö University hospital in Sweden, between 2002 and 2005. The aim of the project was to identify personality and psychosocial factors, influencing patients’ actions and the prognoses after MI. The five factor model of personality, (measures on Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness), coping strategies, depressive symptoms, the impact on delay seeking emergency care, smoking habits and cardiac health care utilization were studied. This thesis reports the result from four papers. In paper I the aim was to investigate whether maladaptive behaviour in the serial Color Word Test (CWT) alone or in combination with any specific personality dimensions were associated with severity of the MI. The indicators of severity of disease were maximum levels above median of the cardiac biomarkers troponin I and creatine-kinase-MB (CKMB), Q-wave infarctions, and a left ventricular ejection fraction (LVEF). The findings showed that maladaptive behaviour in combination with low scores on extraversion was associated with higher levels in cardiac biomarkers, following an MI. Another crucial factor for the prognoses and survival after a MI is early arrival to the emergency department and rapid intervention. In paper II we analysed the correlation of personality and psychosocial factors, with the time lag between the onset of coronary symptoms and seeking emergency hospital care. There was no significant conjunction in time delay and personality factors, coping strategies and depression. In paper III we examined whether personality traits, coping strategies and symptoms of depression were related to smoking cessation after an MI. Out of the 149 patients who smoked at baseline, 2 years follow-up data was available on 133 individuals, of these 44% (n=59) still smoked and 56% (n=74) had stopped smoking during the 2 years. Those who still smoked had lower score in the personality factor agreeableness, more lived alone and were unemployed in contrast to those who had stopped smoking. They also had significantly higher coping scores as confrontational behaviour. Finally, in paper IV we examined whether personality factors and depressive symptoms predicted cardiac health care utilization over the first two years after the MI event. Those MI patients showing traits of Neuroticism at baseline had significantly higher utilization at the out-patient cardiac clinic than those without. Individuals with a high score of depressive symptoms at baseline had instead a higher utilization of social workers and telephone contacts over the two year follow-up. In conclusion, we found that the personality factors extraversion, agreeableness and neuroticism were factors that had impact on MI severity, smoking cessation and out-patient clinic contacts, while delay in seeking acute care was not affected by personality factors, depression or coping strategies. Maladaptive behaviour and a confronting coping strategy influenced MI severity and smoking cessation 2 years after an MI. Taking personality factors and coping strategies more into consideration when caring for patients in cardiac rehabilitation might be indicated.

Place, publisher, year, edition, pages
Malmö University. Faculty of Health and Society, 2016. p. 83
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383 ; 1
Keywords
Acute myocardial infarction, Personality factors, Coping strategies, depression, smoking cessation, Secondary prevention
National Category
Humanities and the Arts
Identifiers
urn:nbn:se:mau:diva-7309 (URN)20214 (Local ID)9789171046666 (ISBN)9789171046673 (ISBN)20214 (Archive number)20214 (OAI)
Note

Paper IV in dissertation as manuscript with title "Personality factors and depression as predictors of health care consumption during the first two years following a myocardial infarction"

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-16Bibliographically approved

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