积累9
周三
Anger,Hostility,andCardiacSymptomsinWomenwithSuspected
CoronaryArteryDisease:
TheWomen’sIschemiaSyndromeEvaluation(WISE)Study
愤怒、敌意和心脏症状在疑似患有冠状动脉疾病女性的(WISE)研究
ABSTRACT
Objective:Todeterminetherelationshipofangerandhostilityto
angiographiccoronaryarterydisease(CAD),symptoms,andfunctionalstatusamongwomenwithsuspectedCAD.
目的:探讨可疑冠心病患者的愤怒和敌对情绪与血管造影术判定为冠状动脉疾病(CAD)的症状和功能状态的关系。
Methods:DatawerecollectedfromwomenwithsuspectedCAD
referredfordiagnosticangiographyintheWomen’sIschemia
SyndromeEvaluation(WISE)Study.CADwasassessedas
angiographicpresence/
absenceofdisease(50%stenosisinanyepicardialcoronaryartery).Hostility/anger,angina,symptoms,andfunctionalstatuswere
assessedbytheCook-MedleyHostilityInventory,SpielbergerAngerExpressionScale,cardiovascularsymptomhistory,andtheDuke
ActivityStatusIndex.
方法:收集例疑似冠心病的女性患者的资料，进行缺血性综合征评估(WISE)研究。冠心病被评估为血管造影存在/或无的疾病(50%心外膜冠状动脉狭窄)。敌意/愤怒、心绞痛、症状和功能状态通过Cook-Medley敌意量表、Spielberger愤怒表达量表、心血管症状史和杜克活动状态指数进行评估。
Results:Logisticregressionrevealedthatanger-out(i.e.,aggressivebehaviorinresponsetoangryfeelings)wasindependentlyassociatedwiththepresence/absenceofangiographicCAD(OR?1.09,CI1.01-1.17).
Angerandhostilitywerehigheramongwomenreportingincreasedcardiovascularsymptoms.InwomenwithoutangiographicCAD,thosewithnonanginalcardiacsymptomshadthehighestanger-out,angerexpression,hostileaffect,andaggressiverespondingscores,andthosewithtypicalanginareportedthelowestfunctionalstatus.AmongwomenwithCAD,functionalstatuswaslowestinwomenwith
atypicalangina.
结果：Logistic回归分析显示，愤怒情绪表达（存在攻击行为表达愤怒情绪）与冠状动脉造影CAD的存在/不存在，均独立相关
（OR?1.09，CI1.01-1.17）。
在报告心血管症状增加的妇女中，愤怒和敌意更高。
在冠状动脉造影显示没有CAD的女性中，那些有非心绞痛心血管疾病症状的女性有最高的愤怒（愤怒表达评分）敌对情绪和攻击性反应评分，而那些有典型心绞痛的女性则报告最低的功能状态。
在造影判定为冠心病患者中，不典型心绞痛患者的功能状态最低。
Conclusions:AmongwomenwithsuspectedCAD,anger-outscoreswereassociatedwiththepresenceofangiographicCAD.
Anger/hostilitytraitswereassociatedwithincreasedsymptoms,
particularlywithnonanginalchestpaininwomenwithout
angiographicCAD.Relationshipsamongpsychosocialfactors,cardiacsymptoms,andangiographicCADarepotentiallyimportantinthemanagementofwomenwithsuspectedCAD.
结论：
在疑似冠心病的女性中，愤怒表达评分与冠状动脉造影CAD的存在相关。愤怒/敌意特征与症状增加有关，特别是在没有冠状动脉造影CAD的女性中，尤其与非心绞痛性胸痛有关。
心理社会因素、心脏症状和血管造影CAD之间的关系在女性疑似CAD的治疗中具有潜在的重要意义。
Womenwithcardiacsymptomsmayalsoneedassistanceincopingwiththeirsymptoms,aswellasthepsychologicaleffects—includinganger—thatac