Women's exhaustion and coronary artery atherosclerosis progression: The Stockholm Female Coronary Angiography Study

• Published in: Psychosomatic medicine 2013-06, Vol.75 (5), p.478-485
• Main Authors: Zimmermann-Viehoff, Frank, Wang, Hui-Xin, Kirkeeide, Richard, Schneiderman, Neil, Erdur, Laurence, Deter, Hans-Christian, Orth-Gomér, Kristina
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Atherosclerosis; Confidence intervals; Coronary angiography; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary Artery Disease - pathology; Coronary Vessels - diagnostic imaging; Coronary Vessels - pathology; Correlation analysis; Depression - epidemiology; Disease Progression; Fatigue; Fatigue - epidemiology; Female; Follow-Up Studies; Humans; Medical imaging; Mental depression; Middle Aged; Models, Statistical; Moods; Myocardial Infarction - epidemiology; Questionnaires; Recurrence; Risk Factors; Surveys and Questionnaires; Sweden; Women; Womens health
• ISSN: 0033-3174; 1534-7796
• DOI: 10.1097/PSY.0b013e3182928c28

Vital exhaustion (VE) has been associated with incident and recurrent cardiac events. The present study investigated the impact of VE on coronary atherosclerosis progression for 3 years. We further aimed to detect the relative importance of the VE subcomponents, fatigue, and depressed mood. 103 women (age range, 30-65 years) who had experienced an acute coronary event underwent quantitative coronary angiography at baseline and again after 3 years. VE and subcomponents were assessed using the Maastricht Questionnaire. VE correlated significantly with coronary artery diameter change for 3 years (r = -0.239, p = .015). When analyzed in quartiles, women of the highest VE level showed the most pronounced coronary artery luminal diameter narrowing (mean = 0.21 mm, 95% confidence interval [CI] = 0.15-0.27), women in the third quartile were intermediate (mean = 0.11 mm, 95% CI = 0.05-0.17), and women within the two lower quartiles showed no significant change. High levels of the depressed mood and fatigue subscales were also associated with coronary artery diameter narrowing (mean = 0.19 mm, 95% CI = 0.12-0.26, p = .003; and mean = 0.17 mm, 95% CI = 0.08-0.26, p = .03, respectively). However, the associations were attenuated when both variables were entered into the model simultaneously: 0.17 mm (95% CI = 0.09-0.25, p = .05) and 0.14 mm (95% CI = 0.03-0.25, p = .67), respectively. VE was associated with accelerated coronary atherosclerosis progression in relatively young women who had experienced an acute coronary event. This association was mainly driven by depressed mood.