title: Inflammation and the mental state before an acute coronary event.
abstract: Feelings of exhaustion have been found to belong to the precursors of acute coronary events. Guided by the current views of the pathogenesis of acute coronary syndromes, a two-stage model describing a feedback relationship between mental state and the disease process is presented. According to the presented model prolonged exposure to stress results in a state of exhaustion leading to increased susceptibility to inflammatory diseases. Inflammation, in turn, amplifies feelings of exhaustion and malaise through cytokine release. Results of a study of 15 exhausted and 15 nonexhausted angioplasty patients, showing elevated levels of interleukin-1beta and tumour necrosis factor-alpha in the exhausted patients, give empirical support to this model.
authors.affiliation: Department of Medical Psychology, University of Maastricht, The Netherlands. ad.appels@mp.unimaas.nl
authors.forename: A
authors.initials: A
authors.lastname: Appels
mesh_terms: D016022:Case-Control Studies; D003327:Coronary Disease / Q000209:etiology / Q000523:psychology*; D016207:Cytokines / Q000378:metabolism*; D005221:Fatigue / Q000150:complications*; D006801:Humans; D007249:Inflammation / Q000150:complications*; D008955:Models, Cardiovascular; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*
chemical_list: D016207:Cytokines