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Hostility Predicts Restenosis After Percutaneous Transluminal Coronary Angioplasty

      Objective

      To investigate the “toxic” total (potential for) hostility component of the type A behavior pattern (assessed by means of the structured interview) as it relates to prediction of restenosis after percutaneous transluminal coronary angioplasty (PTCA).

      Design

      Patients with single vessel or multivessel coronary artery disease in whom PTCA had been scheduled or done were administered the structured interview by one trained interviewer prospectively or retrospectively (blinded to angiographic endpoints).

      Material and Methods

      A total of 41 patients underwent 53 initial balloon dilations on native arteries by 1 of 5 participating cardiologists. Inclusion criteria for this study were a successful initial PTCA and post PTCA recatheterization if a patient complained of ischemic symptoms possibly related to restenosis.

      Results

      Of the 41 patients, 15 (36.6%) had restenoses at a total of 18 previous angiopiasty sites. Patients with high total (potential for) hostility ratings were almost 2.5 times more likely to have restenosis than those with low total (potential for) hostility scores (95% confidence interval = 1.03 to 5.32). Logistic regression revealed that total (potential for) hostility scores predicted post-PTCA restenosis overall as well as when adjusted for gender and race. Total (potential for) hostility scores were also positively associated with the number of arteries restenosed (P = 0.01).

      Conclusion

      This is the first report of type A total (potential for) hostility behavior conferring an increased risk for restenosis after PTCA. Its modification may be effective in reducing recurrent cardiac events. A coronary-prone behavior modification program for patients with persistent, same-site restenosis after PTCA has been initiated.
      CAD (coronary artery disease), MRFIT (Multiple Risk Factor Intervention Trial), PARRFs (postangioplasty restenosis risk factors), PTCA (percutaneous trans luminal coronary angloplasty), SI (structured interview)
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      Linked Article

      • Identification and Treatment of Psychosocial Risk Factors for Coronary Artery Disease
        Mayo Clinic ProceedingsVol. 71Issue 8
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          Since the introduction of the concept of the type A behavior pattern by Friedman and Rosenman in 1959, investigators have had an ongoing interest in the relationship between psychosocial risk factors and the epidemiologic and pathophysiologic features of coronary artery disease. In recent years, emphasis has shifted from attempting to predict the development of coronary artery disease in healthy subjects to evaluating the influence of psychosocial factors on secondary events, health-care costs, and survival in patients with established coronary artery disease.
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