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Psychosocial predictors of long-term mortality among women with suspected myocardial ischemia: the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation

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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.

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Acknowledgments

This work was supported by contracts from the National Heart, Lung and Blood Institutes Nos. N01-HV-68161, N01-HV-68162, N01-HV-68163, N01-HV-68164, grants U0164829, U01 HL649141, U01 HL649241, K23HL105787, T32HL69751, R01 HL090957, 1R03AG032631 from the National Institute on Aging, GCRC Grant MO1-RR00425 from the National Center for Research Resources, the National Center for Advancing Translational Sciences Grant UL1TR000124, and grants from the Gustavus and Louis Pfeiffer Research Foundation, Danville, NJ, The Women’s Guild of Cedars-Sinai Medical Center, Los Angeles, CA, The Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, PA, and QMED, Inc., Laurence Harbor, NJ, the Edythe L. Broad and the Constance Austin Women’s Heart Research Fellowships, Cedars-Sinai Medical Center, Los Angeles, California, the Barbra Streisand Women’s Cardiovascular Research and Education Program, Cedars-Sinai Medical Center, Los Angeles, The Society for Women’s Health Research (SWHR), Washington, D.C., The Linda Joy Pollin Women’s Heart Health Program, and the Erika Glazer Women’s Heart Health Project, Cedars-Sinai Medical Center, Los Angeles, California.

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Authors and Affiliations

  1. VA San Diego Healthcare System, Psychology Service 116B, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA

    Thomas Rutledge

  2. University of California, San Diego, CA, USA

    Thomas Rutledge

  3. University of Pittsburgh, Pittsburgh, PA, USA

    Tanya S. Kenkre, Wafia Eteiba & B. Delia Johnson

  4. Allegheny General Hospital, Pittsburgh, PA, USA

    Diane V. Thompson

  5. University of Alabama at Birmingham, Birmingham, AL, USA

    Vera A. Bittner

  6. Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Kerry Whittaker & David S. Krantz

  7. UCLA School of Nursing, Los Angeles, CA, USA

    Jo-Ann Eastwood

  8. University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Carol E. Cornell

  9. University of Florida, Gainesville, FL, USA

    Carl J. Pepine & Eileen M. Handberg

  10. Barbra Streisand Women’s Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA

    C. Noel Bairey Merz

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  1. Thomas Rutledge
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  2. Tanya S. Kenkre
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  13. C. Noel Bairey Merz
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Correspondence to Thomas Rutledge.

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Conflict of interest

Thomas Rutledge, Tanya S. Kenkre, Diane V. Thompson, Vera A. Bittner, Kerry Whittaker, Jo-Ann Eastwood, Wafia Eteiba, Carol E. Cornell, David S. Krantz, Carl J. Pepine, B. Delia Johnson, Eileen M. Handberg and C. Noel Bairey Merz declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Rutledge, T., Kenkre, T.S., Thompson, D.V. et al. Psychosocial predictors of long-term mortality among women with suspected myocardial ischemia: the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation. J Behav Med 39, 687–693 (2016). https://doi.org/10.1007/s10865-016-9737-7

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  • DOI: https://doi.org/10.1007/s10865-016-9737-7

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