title: Poor health-related quality of life and proactive primary control strategy may act as risk factors for acute coronary syndrome.
abstract: OBJECTIVE
  Increasing evidence supports that psychological factors may be related to development of coronary artery disease (CAD). Although psychological well-being, ill-being, and control strategy factors may play a significant role in CAD, rarely have these factors been simultaneously examined previously. We assessed comprehensive psychological factors in patients with acute coronary syndrome (ACS).
  
  
  METHODS
  A total of 85 ACS patients (56 unstable angina, 29 acute myocardial infarction; 52.6±10.2 years; M/F=68/17) and 63 healthy controls (48.7±6.7 years, M/F=43/20) were included. Socio-demographic information, levels of psychological maladjustment, such as anxiety, hostility, and job stress, health-related quality of life (HRQoL), and primary and secondary control strategy use were collected through self-report questionnaires.
  
  
  RESULTS
  There was no significant difference between the ACS group and control group in levels of anxiety, hostility, and job stress. However, ACS patients had significantly lower scores on the general health perception and bodily pain subscales of HRQoL than the control group. The ACS group, as compared with the controls, tended to use primary control strategies more, although not reaching statistical significance by univariate analysis. Multivariate logistic regression analysis after adjusting age and gender identified the physical domain of HRQoL {odds ratio (OR)=0.40}, primary control strategy (OR=1.92), and secondary control strategy (OR=0.53) as independent predictors of ACS.
  
  
  CONCLUSIONS
  Poor HRQoL and primary control strategy, proactive behaviors in achieving ones' goal, may act as risk factors for ACS, while secondary control strategy to conform to current situation may act as a protective factor for ACS.
authors: Department of Psychology, Yonsei University, Seoul, Korea.
authors: Jihyeon
authors: J
authors: Seo
authors: Division of Cardiology, School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
authors: Yoonpyo
authors: Y
authors: Lee
authors: Division of Cardiology, School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
authors: Seokhyung
authors: S
authors: Kang
authors: Department of Health Promotion Center, School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
authors: Hyejin
authors: H
authors: Chun
authors: Division of Cardiology, School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
authors: Wook Bum
authors: WB
authors: Pyun
authors: Division of Cardiology, School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
authors: Seong-Hoon
authors: SH
authors: Park
authors: Department of Psychology, Yonsei University, Seoul, Korea.
authors: Kyong-Mee
authors: KM
authors: Chung
authors: Division of Cardiology, School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea. ; Ewha Global Top 5 Project, School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.
authors: Ick-Mo
authors: IM
authors: Chung
keywords: Acute coronary syndrome; Psychological stress; Quality of life