ArticleJACC. Advances2024
Psychological Distress and the Risk of Adverse Cardiovascular Outcomes in Patients With Coronary Heart Disease.
Article in JACC. Advances, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Counseling Intervention and Cardiovascular Events in People With Peripheral Artery Disease: A Post Hoc Analysis of the BIP Randomized Clinical Trial.JAMA surgery · 2024Trial
- Biopsychosocial phenogroups in an urban population with coronary artery disease and their associations with adverse cardiovascular events.European heart journal open · 2026Article
- Depression, but not anxiety, is associated with epigenetic age accelerations among Asian older adults.Molecular psychiatry · 2026Article
- Longitudinal Changes in Frailty and Major Adverse Cardiovascular Events in Patients With Coronary Heart Disease.Journal of the American Heart Association · 2026Article
- Childhood adversity and increased cytokine release from peripheral mononuclear cells of CHD patients - a pilot study.BMC cardiovascular disorders · 2026Article
- Article
- Therapeutic efficacy and safety of Shexiang Baoxin Pill in relation to anxiety and depression in patients with coronary heart disease.Medicine · 2026Article
- Cholesterol, high-density lipoprotein, and glucose index as a cardiometabolic marker associated with heart rate variability and 1-year cardiovascular rehospitalization in chronic coronary syndromes with comorbid anxiety: a retrospective cohort study.Frontiers in endocrinology · 2026Article
- Mental stress as a trigger of cardiovascular events: A narrative review.European journal of clinical investigation · 2026Review
- Review
- Investigating the relationship between psychological distress, resilience, and demographic variables among adult men and women with cardiac arrhythmias: a cross-sectional study.Scientific reports · 2025Article
- Integrating Emotional Stress and Lipid Lowering in Cardiovascular Disease Management: The Future of Precision Cardiovascular Prevention.Journal of clinical medicine · 2025Article
- Psychosocial stress and cardiovascular disease.American journal of preventive cardiology · 2025Review
- Brief Mindfulness-Based Cognitive Therapy in Women With Myocardial Infarction: Results of a Multicenter Randomized Controlled Trial.JACC. Advances · 2025Article
- Illness perceptions as predictive factors for anxiety and depressive symptoms among patients with coronary heart disease.Health psychology research · 2025Article
- Stress and cardiovascular disease: an update.Nature reviews. Cardiology · 2024Review
- The Role of Psychosocial Stress on Cardiovascular Disease in Women: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2024Review
- Optimisation of Remote Monitoring Programmes in Heart Failure: Evaluation of Patient Drop-Out Behaviour and Healthcare Professionals' Perspectives.Healthcare (Basel, Switzerland) · 2024Article
- Exploring the Relationship of Anxiety and Depressive Symptoms and Impulsiveness with the Quality of Life of Older Patients with Cardiovascular Disease: A Cross-Sectional Study.International journal of environmental research and public health · 2024Article
- A Sum Greater Than its Parts: A Composite Psychological Distress Score and Cardiovascular Risk.JACC. Advances · 2024Article
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Abstract
backgroundPsychological distress is a recognized risk factor in patients with coronary heart disease (CHD), but its clinical significance is unclear.
objectivesThe purpose of this study was to determine if an index of psychological distress is independently associated with adverse outcomes and significantly contributes to risk prediction.
methodsPooled analysis of 2 prospective cohort studies of patients with stable CHD (N = 891). A psychological distress score was constructed using measures of depression, anxiety, anger, perceived stress, and post-traumatic stress disorder, measured at baseline. The study endpoint included cardiovascular death or first or recurrent nonfatal myocardial infarction or hospitalization for heart failure at 5.9 years.
resultsIn both cohorts, first and recurrent events occurred more often among those in the highest tertile of distress score than those in the lowest tertile. After combining the 2 cohorts, compared with the lowest tertile, the hazards ratio for having a distress score in the highest tertile was 2.27 (95% CI: 1.69-3.06), and for the middle tertile, it was 1.52 (95% CI: 1.10-2.08). Adjustment for demographics and clinical risk factors only slightly weakened the associations. When the distress score was added to a traditional clinical risk model, C-statistic, net reclassification index, and integrative discrimination index all significantly improved.
conclusionsAmong patients with CHD, a composite measure of psychological distress was significantly associated with an increased risk of adverse events and significantly improved risk prediction.
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