title: Emotional coping is a better predictor of cardiac prognosis than depression and anxiety.
abstract: OBJECTIVE
  We compared, in a prospective study on patients with acute coronary syndrome, the predictive effect of a depression or anxiety diagnosis and of emotion-focused, problem-focused and dysfunctional coping strategies, as detected early after an acute event, on patients' left ventricular ejection fraction (LVEF), a reliable prognostic index of disease severity, at a three-month follow up.
  
  
  METHODS
  Ninety consecutive patients following an acute coronary syndrome event (83.3% men; mean age 56.9 ± 8.9 years) were included in the study. Demographic and clinical characteristics, presence of depression and anxiety disorders (MINI), and active use of emotion-focused, problem-focused and dysfunctional coping strategies (Brief Cope) were assessed at the time of enrolment. LVEF at a three-month follow up was used as the outcome measure.
  
  
  RESULTS
  The medical predictors of LVEF accounted for 10.6% of the variance of LVEF at follow up. Emotion-focused coping strategies significantly contributed for an additional 6.1%, while the presence of a depression and/or anxiety disorder was not a significant predictor of LVEF at follow up, nor were dysfunctional and problem-focused coping strategies.
  
  
  CONCLUSIONS
  Emotion-focused coping strategies at the time of the cardiac event were the only reliable psychological predictor of disease severity at a three-month follow up. These findings hint to the possibility that variables such as emotional coping may be a fruitful target for psychological treatments directed at cardiac patients in primary care settings.
authors.affiliation: Center for Cognitive Science, Department of Psychology, University of Turin, Turin, Italy. claudia.chiavarino@unito.it
authors.forename: Claudia
authors.initials: C
authors.lastname: Chiavarino
authors.forename: Daniela
authors.initials: D
authors.lastname: Rabellino
authors.forename: Rita B
authors.initials: RB
authors.lastname: Ardito
authors.forename: Erika
authors.initials: E
authors.lastname: Cavallero
authors.forename: Luigi
authors.initials: L
authors.lastname: Palumbo
authors.forename: Serena
authors.initials: S
authors.lastname: Bergerone
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.forename: Bruno G
authors.initials: BG
authors.lastname: Bara
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000523:psychology; D000223:Adaptation, Psychological / Q000502:physiology; D001007:Anxiety / Q000150:complications / Q000503:physiopathology*; D003863:Depression / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013318:Stroke Volume