title: Women's exhaustion and coronary artery atherosclerosis progression: The Stockholm Female Coronary Angiography Study.
abstract: OBJECTIVE
  Vital exhaustion (VE) has been associated with incident and recurrent cardiac events. The present study investigated the impact of VE on coronary atherosclerosis progression for 3 years. We further aimed to detect the relative importance of the VE subcomponents, fatigue, and depressed mood.
  
  
  METHODS
  103 women (age range, 30-65 years) who had experienced an acute coronary event underwent quantitative coronary angiography at baseline and again after 3 years. VE and subcomponents were assessed using the Maastricht Questionnaire.
  
  
  RESULTS
  VE correlated significantly with coronary artery diameter change for 3 years (r = -0.239, p = .015). When analyzed in quartiles, women of the highest VE level showed the most pronounced coronary artery luminal diameter narrowing (mean = 0.21 mm, 95% confidence interval [CI] = 0.15-0.27), women in the third quartile were intermediate (mean = 0.11 mm, 95% CI = 0.05-0.17), and women within the two lower quartiles showed no significant change. High levels of the depressed mood and fatigue subscales were also associated with coronary artery diameter narrowing (mean = 0.19 mm, 95% CI = 0.12-0.26, p = .003; and mean = 0.17 mm, 95% CI = 0.08-0.26, p = .03, respectively). However, the associations were attenuated when both variables were entered into the model simultaneously: 0.17 mm (95% CI = 0.09-0.25, p = .05) and 0.14 mm (95% CI = 0.03-0.25, p = .67), respectively.
  
  
  CONCLUSIONS
  VE was associated with accelerated coronary atherosclerosis progression in relatively young women who had experienced an acute coronary event. This association was mainly driven by depressed mood.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Charité Universitätsmedizin Berlin, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Zimmermann-Viehoff
authors.forename: Hui-Xin
authors.initials: HX
authors.lastname: Wang
authors.forename: Richard
authors.initials: R
authors.lastname: Kirkeeide
authors.forename: Neil
authors.initials: N
authors.lastname: Schneiderman
authors.forename: Laurence
authors.initials: L
authors.lastname: Erdur
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Deter
authors.forename: Kristina
authors.initials: K
authors.lastname: Orth-Gomér
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D003863:Depression / Q000453:epidemiology*; D018450:Disease Progression; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015233:Models, Statistical; D009203:Myocardial Infarction / Q000453:epidemiology; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: coronary heart disease; depression; fatigue; quantitative coronary angiography; vital exhaustion