PMID- 27357124
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 102
IP  - 22
DP  - 2016 Nov 15
TI  - Psychological stress and short-term hospitalisations or death in patients with 
      heart failure.
PG  - 1820-1825
LID - 10.1136/heartjnl-2015-309154 [doi]
AB  - OBJECTIVE: Standard predictors do not fully explain variations in the frequency 
      and timing of heart failure (HF) adverse events (AEs). Psychological stress can 
      trigger acute cardiovascular (CV) events, but it is not known whether stress can 
      precipitate AEs in patients with HF. We investigated prospective associations of 
      psychological stress with AEs in patients with HF. METHODS: 144 patients with HF 
      (77% male; 57.5+/-11.5, range 23-87 years, left ventricular ejection fraction </=40%) 
      were longitudinally evaluated for psychological stress (Perceived Stress Scale) 
      and AEs (CV hospitalisations/death) at 2-week intervals for 3 months and at 
      9-month follow-up. RESULTS: 42 patients (29.2%) had at least one CV 
      hospitalisation and nine (6.3%) died. Patients reporting high average perceived 
      stress across study measurements had a higher likelihood of AEs during the study 
      period compared with those with lower stress (odds ratio=1.10, 95% confidence 
      interval=1.04 to 1.17). In contrast to average levels, increases in stress did 
      not predict AEs (p=0.96). Perceived stress was elevated after a CV 
      hospitalisation (B=2.70, standard error (SE)=0.93, p=0.004) suggesting that CV 
      hospitalisations increase stress. Subsequent analysis indicated that 24 of 38 
      (63%) patients showed a stress increase following hospitalisation. However, a 
      prospective association between stress and AEs was present when accounting for 
      prior hospitalisations (B=2.43, SE=1.23, p=0.05). CONCLUSIONS: Sustained levels 
      of perceived stress are associated with increased risk of AEs, and increased 
      distress following hospitalisation occurs in many, but not all, patients with HF. 
      Patients with chronically high stress may be an important target group for HF 
      interventions aimed at reducing hospitalisations.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/.
FAU - Endrighi, Romano
AU  - Endrighi R
AD  - Department of Medical and Clinical Psychology, Uniformed Services University of 
      the Health Sciences, Bethesda, Maryland, USA.
AD  - Division of Behavioral Science Research, Department of Health Policy and Health 
      Services Research, Boston University, Boston, Massachusetts, USA.
FAU - Waters, Andrew J
AU  - Waters AJ
AD  - Department of Medical and Clinical Psychology, Uniformed Services University of 
      the Health Sciences, Bethesda, Maryland, USA.
FAU - Gottlieb, Stephen S
AU  - Gottlieb SS
AUID- ORCID: 0000-0002-8922-1840
AD  - University of Maryland School of Medicine, Baltimore, Maryland, USA.
FAU - Harris, Kristie M
AU  - Harris KM
AD  - Cardiopulmonary Behavioral Medicine Laboratory, The Ohio State University, 
      Columbus, Ohio, USA.
FAU - Wawrzyniak, Andrew J
AU  - Wawrzyniak AJ
AD  - Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, 
      Florida, USA.
FAU - Bekkouche, Nadine S
AU  - Bekkouche NS
AD  - Department of Medical and Clinical Psychology, Uniformed Services University of 
      the Health Sciences, Bethesda, Maryland, USA.
FAU - Li, Yisheng
AU  - Li Y
AD  - Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 
      Houston, Texas, USA.
FAU - Kop, Willem J
AU  - Kop WJ
AD  - Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The 
      Netherlands.
FAU - Krantz, David S
AU  - Krantz DS
AUID- ORCID: 0000-0002-1671-1355
AD  - Department of Medical and Clinical Psychology, Uniformed Services University of 
      the Health Sciences, Bethesda, Maryland, USA.
LA  - eng
GR  - P30 CA016672/CA/NCI NIH HHS/United States
GR  - R01 HL085730/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20160629
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
PMC - PMC5237617
MID - NIHMS835933
COIS- Competing interests: None declared.
EDAT- 2016/07/01 06:00
MHDA- 2016/07/01 06:01
PMCR- 2017/12/29
CRDT- 2016/07/01 06:00
PHST- 2015/12/10 00:00 [received]
PHST- 2016/05/31 00:00 [revised]
PHST- 2016/06/01 00:00 [accepted]
PHST- 2016/07/01 06:00 [pubmed]
PHST- 2016/07/01 06:01 [medline]
PHST- 2016/07/01 06:00 [entrez]
PHST- 2017/12/29 00:00 [pmc-release]
AID - heartjnl-2015-309154 [pii]
AID - 10.1136/heartjnl-2015-309154 [doi]
PST - ppublish
SO  - Heart. 2016 Nov 15;102(22):1820-1825. doi: 10.1136/heartjnl-2015-309154. Epub 
      2016 Jun 29.