title: Psychological coping and recurrent major adverse cardiac events following acute coronary syndrome.
abstract: BACKGROUND
  Depressed mood and stress are associated with recurrent adverse outcomes following acute coronary syndrome (ACS), but the impact of psychological coping style has not been evaluated in detail.
  
  
  OBJECTIVE
  We tested the relationship between task-oriented coping and event-free survival following ACS.
  
  
  METHODS
  We followed 158 patients with ACS for an average of 59.8 months for major adverse cardiac outcomes. Psychological coping was assessed with the Coping Inventory of Stressful Situations.
  
  
  RESULTS
  Compared with patients in the lower half of the distribution, those reporting higher task-oriented coping had a reduced hazard of adverse cardiac events (hazard ratio (HR) = 0.28, 95% CI 0.11-0.68, P = 0.005) independently of demographic, clinical and behavioural covariates. The combination of low task-oriented coping and high depressive symptoms showed a strong association with adverse outcomes (HR = 6.25, 95% CI 1.88-20.82, P = 0.003).
  
  
  CONCLUSIONS
  The tendency to cope using task-oriented strategies may promote event-free survival following ACS.
authors.affiliation: Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Nadine
authors.initials: N
authors.lastname: Messerli-Bürgy
authors.affiliation: Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Molloy
authors.affiliation: Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Lydia
authors.initials: L
authors.lastname: Poole
authors.affiliation: Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Wikman
authors.affiliation: Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Kaski
authors.affiliation: Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK a.steptoe@ucl.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
mesh_terms: D054058:Acute Coronary Syndrome / Q000523:psychology*; D000223:Adaptation, Psychological; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D016757:Death, Sudden, Cardiac / Q000209:etiology; D003866:Depressive Disorder / Q000209:etiology*; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011379:Prognosis; D012008:Recurrence; D013315:Stress, Psychological / Q000209:etiology*