A 14-year follow-up study of chest pain patients including stress hormones and mental stress at index event
| Autor: | Inger Bengtsson, Björn W. Karlson, Peter Währborg, Johan Herlitz, Maria Haglid Evander |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Chest Pain Time Factors Epinephrine Hydrocortisone Dopamine Disease Chest pain Angina Norepinephrine Internal medicine Medicine Humans Medical history Sampling (medicine) Pathological business.industry Emergency department Middle Aged medicine.disease Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Stress Psychological Hormone Follow-Up Studies |
| Zdroj: | International journal of cardiology. 154(3) |
| ISSN: | 1874-1754 |
| Popis: | Background Knowledge of long-term outcome in chest pain patients is limited. We reinvestigated patients who 14years earlier had visited the emergency department due to chest pain, and were discharged without hospitalization. Extensive examinations were made at that time on 484 patients including full medical history, exercise test, a battery of stress questions and stress hormone sampling. Methods From a previously conducted chest pain study patients still alive after 14years were approached. Hospitalization or deaths with a diagnosis of ischemic heart disease or cerebrovascular disease were used as end point. Results During the follow-up period 24 patients had died with a diagnosis of ischemic heart or cerebrovascular disease, and 50 patients had been given such a diagnosis at hospital discharge. Age (OR 1.12, CI 1.06–1.19), previous history of angina pectoris (OR 9.69, CI 2.06–71.61), pathological ECG at emergency department visit (OR 3.27, CI 1.23–8.67), hypertension (OR 5.03, CI 1.90–13.76), smoking (OR 3.04, CI 1.26–7.63) and lipid lowering medication (OR 14.9, CI 1.60–152.77) were all associated with future ischemic heart or cerebrovascular events. Noradrenalin levels were higher in the event group than in the non-event group, mean (SD) 2.44 (1.02) nmol/L versus 1.90 (0.75) nmol/L. When noradrenalin was included in the regression model high maximal exercise capacity was protective of an event (OR 0.986, CI 0.975–0.997). Conclusion In chest pain patients previous history of angina pectoris, hypertension, smoking, pathological ECG at primary examination, and age were the main risk factors associated with future cardiovascular or cerebrovascular events. |
| Databáze: | OpenAIRE |
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