title: Psychosocial predictors of long-term mortality among women with suspected myocardial ischemia: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation.
abstract: This paper evaluated long-term associations between psychosocial factors and premature mortality among women with suspected coronary artery disease (CAD). We tracked total mortality events over a median 9.3 years in a cohort of 517 women [baseline mean age = 58.3 (11.4) years]. Baseline evaluations included coronary angiography, psychosocial testing, and CAD risk factors. Measures included the Spielberger Trait Anxiety Scale, Beck Depression Inventory, self-rated health, and Social Network Index. Cox regression analysis was used to assess relationships. Covariates included age, CAD risk factors, and CAD severity. BDI scores (HR 1.09, 95 % CI 1.02-1.15), STAI scores (HR .86, 95 % CI .78-.93), and very good self-rated health (relative to the poor self-rated health group; HR .33, 95 % CI .12-.96) each independently predicted time to mortality outcomes in the combined model. SNI scores (HR .91, 95 % CI .81-1.06) and other self-rated health categories (i.e., fair, good, and excellent categories) were not significant mortality predictors after adjusting for other psychosocial factors. These results reinforce and extend prior psychosocial research in CAD populations.
authors.affiliation: VA San Diego Healthcare System, Psychology Service 116B, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA. thomas.rutledge@med.va.gov.|University of California, San Diego, CA, USA. thomas.rutledge@med.va.gov.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rutledge
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Tanya S
authors.initials: TS
authors.lastname: Kenkre
authors.affiliation: Allegheny General Hospital, Pittsburgh, PA, USA.
authors.forename: Diane V
authors.initials: DV
authors.lastname: Thompson
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Vera A
authors.initials: VA
authors.lastname: Bittner
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Kerry
authors.initials: K
authors.lastname: Whittaker
authors.affiliation: UCLA School of Nursing, Los Angeles, CA, USA.
authors.forename: Jo-Ann
authors.initials: JA
authors.lastname: Eastwood
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Wafia
authors.initials: W
authors.lastname: Eteiba
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Carol E
authors.initials: CE
authors.lastname: Cornell
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Krantz
authors.affiliation: University of Florida, Gainesville, FL, USA.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Pepine
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: B Delia
authors.initials: BD
authors.lastname: Johnson
authors.affiliation: University of Florida, Gainesville, FL, USA.
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Handberg
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
authors.forename: C Noel
authors.initials: CN
authors.lastname: Bairey Merz
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality* / Q000523:psychology; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000401:mortality* / Q000523:psychology; D054555:National Heart, Lung, and Blood Institute (U.S.); D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012720:Severity of Illness Index; D014481:United States
keywords: Coronary artery disease; Prospective; Psychological; Stress; Women