title: Design and baseline data from the Gratitude Research in Acute Coronary Events (GRACE) study.
abstract: BACKGROUND
  Positive psychological constructs, especially optimism, have been linked with superior cardiovascular health. However, there has been minimal study of positive constructs in patients with acute coronary syndrome (ACS), despite the prevalence and importance of this condition. Furthermore, few studies have examined multiple positive psychological constructs and multiple cardiac-related outcomes within the same cohort to determine specifically which positive construct may affect a particular cardiac outcome.
  
  
  METHODS
  The Gratitude Research in Acute Coronary Events (GRACE) study examines the association between optimism/gratitude 2weeks post-ACS and subsequent clinical outcomes. The primary outcome measure is physical activity at 6months, measured via accelerometer, and key secondary outcome measures include levels of prognostic biomarkers and rates of nonelective cardiac rehospitalization at 6months. These relationships will be analyzed using multivariable linear regression, controlling for sociodemographic, medical, and negative psychological factors; associations between baseline positive constructs and subsequent rehospitalizations will be assessed via Cox regression.
  
  
  RESULTS
  Overall, 164 participants enrolled and completed the baseline 2-week assessment; the cohort had a mean age of 61.5+/?10.5years and was 84% men; this was the first ACS for 58% of participants.
  
  
  CONCLUSIONS
  The GRACE study will determine whether optimism and gratitude are prospectively and independently associated with physical activity and other critical outcomes in the 6months following an ACS. If these constructs are associated with superior outcomes, this may highlight the importance of these constructs as independent prognostic factors post-ACS.
authors.affiliation: Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States. Electronic address: jhuffman@partners.org.
authors.forename: Jeff C
authors.initials: JC
authors.lastname: Huffman
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Eleanor E
authors.initials: EE
authors.lastname: Beale
authors.affiliation: Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Beach
authors.affiliation: Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Celano
authors.affiliation: Department of Medicine, Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Arianna M
authors.initials: AM
authors.lastname: Belcher
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Shannon V
authors.initials: SV
authors.lastname: Moore
authors.affiliation: Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Laura
authors.initials: L
authors.lastname: Suarez
authors.affiliation: Harvard Medical School, Boston, MA, United States; Department of Medicine, Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Parul U
authors.initials: PU
authors.lastname: Gandhi
authors.affiliation: Harvard Medical School, Boston, MA, United States; Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, United States.
authors.forename: Shweta R
authors.initials: SR
authors.lastname: Motiwala
authors.affiliation: Harvard Medical School, Boston, MA, United States; Department of Medicine, Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Hanna
authors.initials: H
authors.lastname: Gaggin
authors.affiliation: Harvard Medical School, Boston, MA, United States; Department of Medicine, Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States.
authors.forename: James L
authors.initials: JL
authors.lastname: Januzzi
keywords: Acute coronary syndrome; Coronary artery disease; Gratitude; Optimism; Physical activity