PMID- 16399852
OWN - NLM
STAT- MEDLINE
DCOM- 20060814
LR  - 20181113
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 92
IP  - 8
DP  - 2006 Aug
TI  - Triggering of acute coronary syndromes by physical exertion and anger: clinical 
      and sociodemographic characteristics.
PG  - 1035-40
AB  - OBJECTIVE: To investigate the role of vigorous physical exertion and anger as 
      triggers of acute coronary syndromes (ACS) and to identify the clinical and 
      sociodemographic correlates of triggering. DESIGN: Prospective observational 
      clinical cohort study. SETTING: Four coronary care units in the London area. 
      PATIENTS: 295 men and women with electrocardiographically and biochemically 
      verified ACS. MAIN OUTCOME MEASURES: Physical exertion in the 1 h and anger in 
      the 2 h before symptom onset were assessed with structured interviews. Control 
      periods were the equivalent hours one day earlier and usual rates over the past 
      six months. Data were analysed by case-crossover methods. RESULTS: Physical 
      exertion was reported by 10% and anger by 17.4% of patients in the hazard period. 
      The risk of ACS onset after physical exertion compared with light or no activity 
      was 3.50 (95% confidence interval (CI) 1.37 to 10.6). The risk of onset with 
      anger was 2.06 (95% CI 1.12 to 3.92). Physical exertion during the hazard period 
      was related to an absence of premonitory symptoms, presentation with an ST 
      elevation myocardial infarction (STEMI), low socioeconomic deprivation and higher 
      future cardiovascular risk. Anger during the hazard period was more common in 
      younger, socioeconomically deprived patients who presented with a STEMI. 
      CONCLUSIONS: Triggers are relevant across the spectrum of ACS. The distinct 
      clinical and sociodemographic factors associated with physical exertion and anger 
      suggest that different pathophysiological processes may be involved.
FAU - Strike, P C
AU  - Strike PC
AD  - Department of Epidemiology and Public Health, University College London, 1-19 
      Torrington Place, London WC1E 6BT, UK.
FAU - Perkins-Porras, L
AU  - Perkins-Porras L
FAU - Whitehead, D L
AU  - Whitehead DL
FAU - McEwan, J
AU  - McEwan J
FAU - Steptoe, A
AU  - Steptoe A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20060106
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2006 Aug;92(8):1009-10. PMID: 16467457
MH  - Age Factors
MH  - Aged
MH  - Anger/*physiology
MH  - Angina, Unstable/*etiology
MH  - Epidemiologic Methods
MH  - Exercise/*physiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*etiology
MH  - Sex Factors
MH  - Syndrome
MH  - Time Factors
PMC - PMC1861076
COIS- Competing interests: None declared.
EDAT- 2006/01/10 09:00
MHDA- 2006/08/15 09:00
PMCR- 2009/08/01
CRDT- 2006/01/10 09:00
PHST- 2006/01/10 09:00 [pubmed]
PHST- 2006/08/15 09:00 [medline]
PHST- 2006/01/10 09:00 [entrez]
PHST- 2009/08/01 00:00 [pmc-release]
AID - hrt.2005.077362 [pii]
AID - ht77362 [pii]
AID - 10.1136/hrt.2005.077362 [doi]
PST - ppublish
SO  - Heart. 2006 Aug;92(8):1035-40. doi: 10.1136/hrt.2005.077362. Epub 2006 Jan 6.