title: [Comparison of psychosocial risk factors between patients who experience acute myocardial infarction before and after 40 years of age].
abstract: OBJECTIVE
  Several studies have shown that psychosocial risk factors such as stress and depression make substantial contribution to the pathogenesis of coronary artery disease. This study aimed to investigate acute stress factors prior to acute myocardial infarction (AMI), and stress, depression, and anxiety levels during the subacute period in AMI patients aged ≤ 40 years, in comparison with AMI patients aged >40 years.
  
  
  METHODS
  The study included 200 first-time AMI patients aged ≤ 40 years (n=100; mean age 35 ± 4 years) and >40 years (n=100; mean age 54 ± 9 years). The DASS 21 scale (Depression Anxiety Stress Scales) was administered via face-to-face interviews in the early recovery period of AMI. The patients were also questioned whether they had experienced acute stress factors such as severe emotional or physical stressful events within two hours before the onset of chest pain. In addition, coronary angiography results were assessed based on the two age groups.
  
  
  RESULTS
  Comparison of the two age groups showed significantly higher frequencies of family history of CAD and smoking in the younger group, and significantly higher frequencies of hypertension, diabetes mellitus, and dyslipidemia in the older group (p<0.05). History of acute stress factors was significantly more common (52% vs. 20%, p<0.01) and stress, depression, and anxiety scores of the DASS 21 scale were all significantly higher in the younger group (p<0.01). On coronary angiography, younger patients predominantly had normal coronary arteries and single-vessel disease, whereas multi-vessel disease was more prevalent in the older age group (p<0.01).
  
  
  CONCLUSIONS
  Triggers of acute stress and psychosocial risk factors may contribute to the occurrence of AMI in individuals younger than 40 years.
authors: Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, İstanbul, Turkey. drcsengul@yahoo.com
authors: Cihan
authors: C
authors: Sengül
authors: Olcay
authors: O
authors: Ozveren
authors: Cihan
authors: C
authors: Cevik
authors: Cemil
authors: C
authors: Izgi
authors: Yusuf
authors: Y
authors: Karavelioğlu
authors: Vecih
authors: V
authors: Oduncu
authors: Taylan
authors: T
authors: Akgün
authors: Mehmet Mustafa
authors: MM
authors: Can
authors: Nihal
authors: N
authors: Ozdemir
authors: Mehmet
authors: M
authors: Ozkan
mesh_terms: D000328:Adult; D000367:Age Factors; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000523:psychology*; D003863:Depression; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008347:Manifest Anxiety Scale; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological; D014421:Turkey