Extracardiac contributions to chest pain perception in patients 6 months after acute myocardial infarction

被引:33
|
作者
Ladwig, KH
Röll, G
Breithardt, G
Borggrefe, M
机构
[1] Tech Univ Munich, Klinikum Rechts Isar, Inst & Poliklin Pschos Med Psychoth & Med Psych, D-81675 Munich, Germany
[2] GSF Forschungszentrum Umwelt & Gesundheit, Inst Med Informat & Systemforschung, Munich, Germany
[3] Univ Munich, Med Klin & Poliklin, Munich, Germany
关键词
D O I
10.1016/S0002-8703(99)70502-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives The amount of perceived anginal pain in patients after infarction deserves the attention of the physician. This study sought to identify the modulating influence of extracardiac factors an persistent angina pectoris after myocardial infarction. Methods and Results A total of 552 male survivors of, acute myocardial infarction (age 29 to 65 years, median 54 years) were followed for a period of 6 months; the affective state was assessed immediately after the acute event. The prognostic importance of postinfarction depression on chest pain perception was evaluated 6 months after the cardiac event in 376 patients. After the 6-month follow-up period, 199 (53%) of the patients with myocardial infarction had angina pectoris. Somatic risk factors and electrocardiographic data at initial testing did not contribute to the risk of having chest pain. However, patients with high level; of depression at initial testing had an almost 3-fold risk of having angina pectoris 6 months after the index event. Older age, lower social class status, and preinfarction angina were also significantly related to angina pectoris at the end of the study. Patients who were pain free before the index infarction reported significantly more symptoms of chest pain at the study end point (P less than or equal to .02), when they had moderate to high degrees of postinfarction depression. In the logistic regression model, depression, then followed by preinfarction angina pectoris and low social class index, contributed significantly to the prediction of follow-up angina :pectoris. Conclusions The results of this study add evidence to the hypothesis that the perception of chest pain may be triggered not only by the nociceptive stimulation of the ischemic heart but also by extrarcardiac sources. Depressive mood state, when concomitant with cardiac disease, is shown to intensify perceived chest pain.
引用
收藏
页码:528 / 534
页数:7
相关论文
共 50 条
  • [21] EFFECT OF METOPROLOL ON CHEST PAIN IN ACUTE MYOCARDIAL-INFARCTION
    HERLITZ, J
    HJALMARSON, A
    HOLMBERG, S
    PENNERT, K
    SWEDBERG, K
    VEDIN, A
    WAAGSTEIN, F
    WALDENSTROM, A
    WEDEL, H
    WILHELMSEN, L
    WILHELMSSON, C
    BRITISH HEART JOURNAL, 1984, 51 (04): : 438 - 444
  • [22] TIME OF ONSET OF CHEST PAIN IN ACUTE MYOCARDIAL-INFARCTION
    THOMPSON, DR
    BLANDFORD, RL
    SUTTON, TW
    MARCHANT, PR
    INTERNATIONAL JOURNAL OF CARDIOLOGY, 1985, 7 (02) : 139 - 146
  • [23] Cocaine-Associated Chest Pain and Acute Myocardial Infarction
    McCord, James
    REVISTA ESPANOLA DE CARDIOLOGIA, 2010, 63 (09): : 1013 - 1014
  • [24] EFFECT OF METOPROLOL ON CHEST PAIN IN ACUTE MYOCARDIAL-INFARCTION
    ERNST, E
    MATRAI, A
    BRITISH HEART JOURNAL, 1984, 52 (02): : 240 - 240
  • [25] THE EFFECT OF STREPTOKINASE ON CHEST PAIN IN ACUTE MYOCARDIAL-INFARCTION
    CHRISTENSEN, JH
    SORENSEN, HT
    RASMUSSEN, SE
    RAVN, L
    NIELSEN, FE
    PAIN, 1991, 46 (01) : 31 - 34
  • [26] Troponins in chest pain patients: are we transforming unstable angina into acute myocardial infarction or not?
    Bassan, R
    Potsch, A
    Tura, B
    Viegas, M
    Gamarski, R
    Masetto, AC
    Moutinho, MA
    EUROPEAN HEART JOURNAL, 2004, 25 : 495 - 495
  • [27] PREDICTIVE VALUE OF ROSE QUESTIONNAIRE FOR MYOCARDIAL-INFARCTION IN PATIENTS WITH ACUTE CHEST PAIN
    HAYWOOD, LJ
    DEGUZMAN, M
    NORRIS, S
    BLUMFIELD, D
    BUTT, E
    FAUCETT, C
    SOBEL, E
    CLINICAL RESEARCH, 1994, 42 (01): : A63 - A63
  • [28] Epidemiology and Serum Metabolic Characteristics of Acute Myocardial Infarction Patients in Chest Pain Centers
    Deng, Dazhi
    Liu, Ling
    Xu, Guangma
    Gan, Jianting
    Shen, Yin
    Shi, Ying
    Zhu, Ruikai
    Lin, Yingzhong
    IRANIAN JOURNAL OF PUBLIC HEALTH, 2018, 47 (07) : 1017 - 1029
  • [29] Chest pain in acute myocardial infarction among diabetic and non-diabetic patients
    Paim, Crislaine Padilha
    Azzolin, Karina de Oliveira
    Pereira de Moraes, Maria Antonieta
    REVISTA BRASILEIRA DE ENFERMAGEM, 2012, 65 (01) : 77 - 82
  • [30] Absence of chest pain and long-term mortality in patients with acute myocardial infarction
    Bjorck, Lena
    Nielsen, Susanne
    Jernberg, Tomas
    Zverkova-Sandstrom, Tatiana
    Giang, Kok Wai
    Rosengren, Annika
    OPEN HEART, 2018, 5 (02):