Background: Women with myocardial infarction (MI) are more likely to have elevated stress levels and depression than men with MI.
Objectives: We investigated psychosocial factors in women with myocardial infarction with nonobstructive coronary arteries (MINOCA) and those with MI and obstructive coronary artery disease (CAD).
Methods: Women with MI enrolled in a multicenter study and completed measures of perceived stress (Perceived Stress Scale-4) and depressive symptoms (Patient Health Questionnaire-2) at the time of MI (baseline) and 2 months later. Stress, depression, and changes over time were compared between MI subtypes.
Results: We included 172 MINOCA and 314 MI-CAD patients. Women with MINOCA were younger (age 59.4 years vs 64.2 years; P < 0.001) and more diverse than those with MI-CAD. Women with MINOCA were less likely to have high stress (Perceived Stress Scale-4 ≥6) at the time of MI (51.0% vs 63.0%; P = 0.021) and at 2 months post-MI (32.5% vs 46.3%; P = 0.019) than women with MI-CAD. There was no difference in elevated depressive symptoms (Patient Health Questionnaire-2 ≥2) at the time of MI (36% vs 43%; P = 0.229) or at 2 months post-MI (39% vs 40%; P = 0.999). No differences in the rate of 2-month decline in stress and depression scores were observed between groups.
Conclusions: Stress and depression are common among women at the time of and 2 months after MI. MINOCA patients were less likely to report high stress compared with MI-CAD patients, but the frequency of elevated depressive symptoms did not differ between the 2 groups. Stress and depressive symptoms decreased in both MI-CAD and MINOCA patients over time.
Competing Interests: Funding Support and Author Disclosures This study was funded by American Heart Association Go Red for Women Strategically Focused Research Network grant 16SFRN27810006. Dr. Hausvater is supported by the National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI) (NIH T32HL098129). Dr Smilowitz is supported, in part, by the NIH/NHLBI under Award Number K23HL150315; and has served on an advisory board as a consultant to Abbott Vascular. Dr Shah receives grant funding from the NIH/NHLBI (1R01HL146206, 3R01HL146206-02S1) and VA Office of Research and Development (CSP 2002, I01CX002358); has served on the advisory boards for Philips Volcano and Horizons Therapeutics; has served as a consultant for Terumo medical; has served on the data safety monitoring board for Heartflow’s PRECISE trial (Cardiovascular Research Foundation) and Encompass ET02; and has served on the Clinical Events Committees for Abbott’s SPIRIT-48 and Concept Medical’s ABILITY-DM trials (Icahn School of Medicine at Mount Sinai). Dr Wei has served as a consultant for an Abbott advisory board on coronary microvascular dysfunction (paid to institution). Dr Har has served as a speaker for Abbott. Dr Hochman has served as Principal Investigator for the ISCHEMIA trial, for which, in addition to support by an NHLBI grant, devices and medications were provided by Abbott Vascular, Medtronic, Inc, St Jude Medical, Inc, Volcano Corporation, Arbor Pharmaceuticals, LLC, AstraZeneca Pharmaceuticals, LP, Merck Sharp and Dohme Corp, and Omron Healthcare, Inc, and financial donations were provided by Arbor Pharmaceuticals, LLC, and AstraZeneca Pharmaceuticals, LP; and has served as Principal Investigator for ISCHEMIA-EXTEND. Dr Reynolds has received grants from the NHLBI during the conduct of the study; and has received support from Abbott Vascular (donation of optical coherence tomography catheters for an unrelated research study) and Biotelemetry Inc (donation of telemetry monitors for an unrelated research study). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)