Psychosocial Stress and Risk of Myocardial Infarction: A Case-Control Study in Belgrade (Serbia).
BACKGROUND
The purpose of this study was to investigate which psychosocial risk factors show the strongest association with occurrence of myocardial infarction (MI) in the population of Belgrade in peacetime, after the big political changes in Serbia.


METHODS
A case-control study was conducted involving 154 consecutive newly diagnosed patients with MI, and 308 controls matched by gender, age, and place of residence.


RESULTS
According to conditional logistic regression analysis, after adjustment for conventional coronary risk factors, the odds ratios (95% confidence intervals) for work-related stressful events, financial stress, deaths and diseases, and general stress were 3.78 (1.83-7.81), 3.80 (1.96-7.38), 1.69 (1.03-2.78), and 3.54 (2.01-6.22), respectively. Among individual stressful life events, the following were independently related to MI: death of a close family member, 2.21 (1.01-4.84); death of a close friend, 42.20 (3.70-481.29); major financial problems, 8.94 (1.83-43.63); minor financial problems, 4.74 (2.02-11.14); changes in working hours, 4.99 (1.64-15.22); and changes in working conditions, 30.94 (5.43-176.31).


CONCLUSIONS
During this political transition period , stress at work, financial stress, and stress in general as they impacted the population of Belgrade, Serbia were strongly associated with occurence of MI.
Institute of Epidemiology;
Isidora
I
Vujcic
Institute of Epidemiology;
Hristina
H
Vlajinac
Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade;
Eleonora
E
Dubljanin
Clinic of Cardiovascular Diseases;
Zorana
Z
Vasiljevic
Clinic of Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Belgrade, Serbia.
Dragana
D
Matanovic
Institute of Epidemiology;
Jadranka
J
Maksimovic
Institute of Epidemiology;
Sandra
S
Sipetic
Case-control study; Myocardial infarction; Psychosocial stress