Patients who remain optimistic and cope positively after coronary angioplasty significantly reduce their risk of a subsequent heart attack or other coronary event, new research shows.
"Above and beyond the contributions of demographic and medical risk factors, patients' cognitive approaches and responses to their illness may influence the onset of new coronary events," said study leader Vicki S. Helgeson, Ph.D., Carnegie Mellon University.
Helgeson, along with Heidi L. Fritz of the University of Pittsburgh, studied 298 patients who received coronary angioplasty to open a blockage in one of their coronary arteries. Patients completed a series of standard questionnaires designed to measure their ability to develop a positive outlook about their medical condition, restore their self-esteem, and find ways to gain control of the situation. Patients' scores on these factors were combined into a single 'cognitive adaptation' index.
Overall, 20 percent of the group suffered a new heart attack, required another angioplasty, bypass surgery, or experienced another heart-related complication in the six months after the initial angioplasty procedure.
Helgeson and Fritz found that patients with higher cognitive adaptation scores were less likely to experience a new heart attack or other coronary event six months after their angioplasty compared with patients with lower scores.
"Patients who scored in the lower third of the index were three times as likely as patients who scored in the upper third of the index to sustain a new coronary event," said Helgeson. The researchers report their findings in the current issue of Psychosomatic Medicine.
Why patients high in cognitive adaptation remain at lower risk for a new coronary event is unclear, the investigators say. It is possible that cognitive adaptation alters people's perception of stress or it reduces the number of stressful events people experience. People who score high on the cognitive adaptation index also may take better care of themselves. Alternatively, cognitive adaptation may have a direct, but not yet defined, effect on the physiological process that leads blood vessels to re-occlude following angioplasty.
The research was supported by the National Institutes of Health.
Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society, published bimonthly. For information about the journal, contact Joel E. Dimsdale, MD, at 619-543-5468.
Posted by the Center for the Advancement of Health http://www.cfah.org. For information about the Center, call Petrina Chong, pchong@cfah.org 202-387-2829.
Journal
Psychosomatic Medicine