קרדיולוגיהבעריכת ד"ר מנחם נהיר

Mental-Stress Induced Ischaemia May Predict Death

Circulation

04/24/2002
By Robert Short

Ischaemia, induced by mental stress, can predict subsequent death in patients with coronary artery disease and exercise-induced ischaemia.

Dr David Sheps and colleagues from the University of Florida College of Medicine, the Malcom Randall Veterans Affairs Medical Center, and the Medical Research Service of the Department of Veterans Affairs, Gainesville, Florida, United States, undertook this investigation. One hundred and ninety six patients from the Psychophysiological Investigations of Myocardial Ischemia (PIMI) study were followed.

All the patients had coronary artery disease and exercise-induced ischaemia. They underwent bicycle exercise and psychological stress testing combined with radionuclide imaging. The researchers confirmed the patients' vital status by telephone, Social Security records searched at three and a half years later and again at five years.

Seventeen of the patients had died. Of these, new or worsened wall-motion abnormalities had been seen during the speech test in 40 percent compared with 19 percent of the survivors and this had significantly predicted death (rate ratio 3.0; 95 percent CI 1.04-8.36; P=0.04). Other indicators of ischaemia during the speech test did not predict death.

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