Cognitive adaptation as a predictor of new coronary events after percutaneous transluminal coronary angioplasty.
OBJECTIVE
We tested whether the psychological components of cognitive adaptation theory would predict new coronary events after a first percutaneous transluminal coronary angioplasty (PTCA).


METHODS
A consecutive sample of patients treated successfully with PTCA were enrolled in the study. Of 343 patients approached, 303 (88%) agreed to participate and were interviewed shortly before hospital discharge. We measured the components of cognitive adaptation theory (optimism, self-esteem, and mastery) during the interview. Five patients were excluded from the analysis because of early, in-hospital reocclusion. New cardiac events (coronary artery bypass grafting, PTCA, myocardial infarction, or disease progression) were examined within 6 months of the first PTCA. We obtained 6-month follow-up data on 98% of patients.


RESULTS
The cognitive adaptation index predicted new cardiac events, even when demographic variables and medical variables thought to predict restenosis were statistically controlled (p = .02).


CONCLUSIONS
These results suggest that persons who respond to their illness by perceiving control over their futures, by having positive expectations about their futures, and by holding a positive view of themselves seem to be at less risk for a new cardiac event after a first PTCA.
Helgeson
V S
VS
Psychology Department, Carnegie Mellon University, Pittsburgh, PA 15213, USA. vh2e+@andrew.cmu.edu
Fritz
H L
HL
D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003071:Cognition / Q000502:physiology*; D001026:Coronary Artery Bypass / Q000379:methods; D003327:Coronary Disease / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy*; D003710:Demography; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index