Psychosocial factors are preventive against coronary events in Japanese men with coronary artery disease: The Eastern Collaborative Group Study 7.7-year follow-up experience

BioPsychoSocial Medicine

Reiko Hori³  Jun-ichiro Hayano⁴  Kazuhiro Kimura²  Nitaro Shibata¹  Fumio Kobayashi³ 

[1] Shinjyuku Mitui Clinic, Tokyo, Japan

[2] Kimura Clinic, Kouka, Japan

[3] Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, 1-1 Yazako Karimata, Nagakute 480-1195, Aichi, Japan

[4] Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan

关键词: Japanese;    Psychosocial factor;    Behavioural medicine;    Risk;    Prognosis;    Coronary artery disease;   

Others  :  1121313
DOI  :  10.1186/s13030-015-0030-8

 received in 2014-03-17, accepted in 2015-01-12,  发布年份 2015

【 摘 要 】

Background

The Japanese Coronary-prone Behaviour Scale (JCBS) is a questionnaire developed by the Eastern Collaborative Group Study (ECGS), a multi-centre study of coronary-prone behaviour among Japanese men. Subscale C of the JCBS consists of 9 items that have been independently associated with the presence of coronary artery disease (CAD) in patients undergoing coronary angiography (CAG). There have been no reports of a relationship between any behavioural factor and the prognosis of CAD in Japan. The purpose of the current study was to investigate behavioural correlations with the prognosis of CAD as a part of the ECGS.

Methods

We examined the mortality and coronary events of 201 men (58 ± 10, 27-86 years) enrolled in the ECGS from 1990 to 1995, who underwent diagnostic coronary angiography and were administered the JCBS and the Japanese version of the Jenkins Activity Survey (JAS) Form C. Their health information after CAG was determined by a review of their medical records and by telephone interviews that took place from 2002 to 2003.

Results

Cardiac events during the follow-up period (7.7 ± 4.2 years) included 13 deaths from CAD, 25 cases of new-onset myocardial infarction, 26 cases of percutaneous coronary intervention, and 19 cases of coronary artery bypass graft surgery. There was no difference in established risk factors between groups with and without cardiac events. Seven factors were extracted by principal component analysis in order to clarify which factors were measured by the JCBS. Stepwise multivariate Cox-hazard regression analysis, in which 9 standard coronary risk factors were forced into the model, showed that Factor 4 from the JCBS (namely, the Japanese spirit of ‘Wa’) was independently associated with coronary events (hazard ratio: 0.21; p = 0.01). By other Cox-hazards regression analyses of coronary events using each set of JAS scores and the JCBS Scale C score instead of Factor 4 as selectable variables, the JAS scores or the JCBS Scale C score were not entered into the models.

Conclusion

The Japanese spirit of ‘Wa’ is a preventive factor against coronary events for Japanese men with CAD.

【 授权许可】

   
2015 Hori et al.; licensee BioMed Central.

【 参考文献 】

• [1]Jenkins CD, Zyzanski SJ, Rosenman RH: Progress toward validation of a computer-scored test for the type A coronary-prone behavior pattern. Psychosom Med 1971, 33(3):193-202.
• [2]Gulliksson M, Burell G, Vessby B, Lundin L, Toss H, Svardsudd K: Randomized controlled trial of cognitive behavioral therapy vs standard treatment to prevent recurrent cardiovascular events in patients with coronary heart disease: Secondary Prevention in Uppsala Primary Health Care project (SUPRIM). Arch Intern Med 2011, 171(2):134-140.
• [3]Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case–control study. Lancet. 2004;364(9438):953–62.
• [4]Monou H, Kimura K, Hayano J, Hosaka T, Shibata N. Deveropment of a New Scale (JCBS) assessing Coronary-Prone Behavior Pattern among Japanese. Type A. (in Japanese) 1990;1(1):19–29.
• [5]Hayano J, Kimura K, Hosaka T, Shibata N, Fukunishi I, Yamasaki K, et al. Coronary disease-prone behavior among Japanese men: job-centered lifestyle and social dominance. Type A Behavior Pattern Conference. Am Heart J. 1997;134(6):1029–36.
• [6]Hori R, Hayano J, Monou H, Kimura K, Tsuboi H, Kamiya T, et al. Coronary-prone behavior among Japanese men. Circ J. 2003;67(2):129–32.
• [7]Ikeda A, Iso H, Kawachi I, Inoue M, Tsugane S: JPHC Study Group: Type A behaviour and risk of coronary heart disease: the JPHC Study. Int J Epidemiol 2008, 37(6):1395-1405.
• [8]Carney RM, Rich MW, Freedland KE, Saini J, teVelde A, Simeone C, et al. Major depressive disorder predicts cardiac events in patients with coronary artery disease. Psychosom Med. 1988;50(6):627–33.
• [9]Frasure-Smith N, Lesperance F, Talajic M: Depression and 18-month prognosis after myocardial infarction. Circulation 1995, 91(4):999-1005.
• [10]Barefoot JC, Helms MJ, Mark DB, Blumenthal JA, Califf RM, Haney TL, et al. Depression and long-term mortality risk in patients with coronary artery disease. Am J Cardiol. 1996;78(6):613–7.
• [11]Denollet J, Brutsaert DL: Personality, disease severity, and the risk of long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction. Circulation 1998, 97(2):167-173.
• [12]Frasure-Smith N, Lesperance F, Juneau M, Talajic M, Bourassa MG: Gender, depression, and one-year prognosis after myocardial infarction. Psychosom Med 1999, 61(1):26-37.
• [13]Frasure-Smith N, Lesperance F, Gravel G, Masson A, Juneau M, Talajic M, et al. Social support, depression, and mortality during the first year after myocardial infarction. Circulation. 2000;101(16):1919–24.
• [14]Chandra V, Szklo M, Goldberg R, Tonascia J: The impact of marital status on survival after an acute myocardial infarction: a population-based study. Am J Epidemiol 1983, 117(3):320-325.
• [15]Ruberman W, Weinblatt E, Goldberg JD, Chaudhary BS: Psychosocial influences on mortality after myocardial infarction. N Engl J Med 1984, 311(9):552-559.
• [16]Wiklund I, Oden A, Sanne H, Ulvenstam G, Wilhelmsson C, Wilhelmsen L: Prognostic importance of somatic and psychosocial variables after a first myocardial infarction. Am J Epidemiol 1988, 128(4):786-795.
• [17]Ahern DK, Gorkin L, Anderson JL, Tierney C, Hallstrom A, Ewart C, et al. Biobehavioral variables and mortality or cardiac arrest in the Cardiac Arrhythmia Pilot Study (CAPS). Am J Cardiol. 1990;66(1):59–62.
• [18]Case RB, Moss AJ, Case N, McDermott M, Eberly S: Living alone after myocardial infarction. Impact on prognosis. JAMA 1992, 267(4):515-519.
• [19]Williams RB, Barefoot JC, Califf RM, Haney TL, Saunders WB, Pryor DB, et al. Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. JAMA. 1992;267(4):520–4.
• [20]Berkman LF, Leo-Summers L, Horwitz RI: Emotional support and survival after myocardial infarction. A prospective, population-based study of the elderly. Ann Intern Med 1992, 117(12):1003-1009.
• [21]Gorkin L, Schron EB, Brooks MM, Wiklund I, Kellen J, Verter J, et al. Psychosocial predictors of mortality in the Cardiac Arrhythmia Suppression Trial-1 (CAST-1). Am J Cardiol. 1993;71(4):263–7.
• [22]Jenkinson CM, Madeley RJ, Mitchell JR, Turner ID: The influence of psychosocial factors on survival after myocardial infarction. Public Health 1993, 107(5):305-317.
• [23]Woloshin S, Schwartz LM, Tosteson AN, Chang CH, Wright B, Plohman J, et al. Perceived adequacy of tangible social support and health outcomes in patients with coronary artery disease. J Gen Intern Med. 1997;12(10):613–8.
• [24]Barth J, Schneider S, von Kanel R: Lack of social support in the etiology and the prognosis of coronary heart disease: a systematic review and meta-analysis. Psychosom Med 2010, 72(3):229-238.
• [25]Shiotani I, Sato H, Kinjo K, Nakatani D, Mizuno H, Ohnishi Y, et al. Depressive symptoms predict 12-month prognosis in elderly patients with acute myocardial infarction. J Cardiovasc Risk. 2002;9(3):153–60.
• [26]Shiozaki M, Iso H, Ohira T, Nakatani D, Shimizu M, Sakata Y, et al. Longitudinal risk of cardiovascular events in relation to depression symptoms after discharge among survivors of myocardial infarction. Osaka Acute Coronary Insufficiency Study. Circ J. 2011;75(12):2878–84.
• [27]Inoue S, Yorifuji T, Takao S, Doi H, Kawachi I: Social cohesion and mortality: a survival analysis of older adults in Japan. Am J Public Health 2013, 103(12):e60. -6
• [28]Lett HS, Blumenthal JA, Babyak MA, Strauman TJ, Robins C, Sherwood A: Social support and coronary heart disease: epidemiologic evidence and implications for treatment. Psychosom Med 2005, 67(6):869-878.
• [29]Rozanski A, Blumenthal JA, Davidson KW, Saab PG, Kubzansky L: The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. J Am Coll Cardiol 2005, 45(5):637-651.