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European Heart Journal 1994 15(4):472-478;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Life event stress and myocardial reinfarction: a prospective study

C. C. TENNANT*,, K. J. PALMER*, P. M. LANGELUDDECKE*, M. P. JONES{dagger} and G. NELSON{ddagger}

* Sydney University Department of Psychiatry Royal North Shore Hospital, St. Leonards, Sydney 2065, Australia
{dagger}Department of Cardiology Royal North Shore Hospital, St. Leonards, Sydney 2065, Australia
{ddagger}Department of Health Information Systems Royal North Shore Hospital, St. Leonards, Sydney 2065, Australia

Received 26 July 1993; revised 27 November 1993; .

Correspondence: Professor C. Tennant, Department of Academic Psychiatry, Royal North Shore Hospital, Pacific Highway, St. Leonards, NSW, 2065, Australia

Abstract

Earlier studies of life event stress in coronary heart disease (CHD) have been flawed by cross-sectional design and inadequate methods for assessing life-event stress. This 3-year prospective study of acute myocardial infarct (AMI) patients reveals significant independent associations between acute and chronic stressors at first admission, and risk of recurrent AMI and death, occurring in the 3 years of follow-up. Relative risks of reinfarction (or death from reinfarction) in the entire sample, for acute events and chronic difficulties were, 2·5 and 2·3 respectively and were statistically significant; When subjects admitted with first AMI were considered alone, relative risks were 3·1 and 4·1 respectively. The clinical significance of these findings is discussed.

Key Words: Life event stress • myocardial reinfarction


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