Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/23220
Title: Sex-Specific Differences in Percutaneous Coronary Intervention Outcomes After a Cardiac Event: A Cohort Study Examining the Role of Depression, Worry and Autonomic Function.
Authors: O'Neil, Adrienne;Scovelle, Anna J;Thomas, Emma;Russell, Josephine D;Taylor, C Barr;Hare, David L;Toukhsati, Samia R;Oldroyd, John;Rangani, W P Thanuja;Dheerasinghe, D S Anoja F;Oldenburg, Brian
Affiliation: Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
School of Health and Life Sciences, Federation University, Melbourne, Vic, Australia
Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic, Australia
Institute for Innovation in Mental and Physical Health and Clinical Treatment, Deakin University, Geelong, Vic, Australia
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia
School of Medicine, The University of Melbourne, Melbourne, Vic, Australia
Department of Psychiatry, Stanford and Palo Alto Universities, Palo Alto, CA, USA
Issue Date: 20-Mar-2020
EDate: 2020-03-20
Citation: Heart, lung & circulation 2020; online first: 20 March
Abstract: To determine whether differential all-cause hospital readmission exists for men and women 2 years after percutaneous coronary intervention (PCI) treatment for acute coronary syndrome (ACS), and to identify potential autonomic and psychological pathways contributing to this association. Four hundred and sixteen (416) patients admitted with ACS were recruited from coronary care wards. Participants attended the study centre at one (T0) and 12 (T1) months following discharge. Heart rate variability (HRV) was used to assess autonomic functioning measured via a three-lead electrocardiogram. Psychological variables of interest (pathological worry, depression and phobic anxiety) were measured using validated self-report questionnaires. Percutaneous coronary intervention treatment data were collected from hospital records. The primary outcome was 2-year all-cause hospital readmission (yes/no). Logistic regression modelling using both complete case analysis and multiple imputation analysis was applied. Men who received PCI had a significant reduction in the odds of being rehospitalised over the following 2 years, relative to women who did not (OR=0.45, 95% CI=0.20, 0.98). No other group benefited to this extent. Adjustment for age, ACS severity and Very Low Frequency (VLF) Power appeared to strengthen the association in both the complete case analysis and multiple imputation analysis models. The inclusion of depression and worry also marginally explained these associations in the multiple imputation analysis model. Men who receive PCI after ACS were less likely to be readmitted to hospital over the following 2 years than their female counterparts. The small sample size of women and observational study design limit interpretation of the findings. However, heart rate variability, specifically VLF power, requires further investigation as a driver of such sex-specific outcomes.
URI: http://ahro.austin.org.au/austinjspui/handle/1/23220
DOI: 10.1016/j.hlc.2020.03.001
PubMed URL: 32414636
Type: Journal Article
Subjects: Acute coronary syndrome
Depression
Heart rate variability
Percutaneous coronary intervention
Psychophysiology
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.