PERCEIVED STRESS IN PATIENTS WITH CORONARY ARTERY DISEASE DURING THE COVID-19 PANDEMIC

Abstract

"Introduction: The COVID-19 pandemic has brought many routine changes to the entire Brazilian population. On mental health, individuals were observed to be increasingly susceptible to developing symptoms such as psychological stress, anxiety, and depression due to social restrictions. The psychosocial factors exerted a fundamental role in the etiology and evolution of cardiovascular diseases (CVDs), with stress being one of these factors. Objective: To evaluate the self-perceived stress on arterial coronary disease patients during the COVID-19 pandemic. Methods: Coronary artery disease patients undergoing percutaneous coronary intervention in the period between February and May 2020 at a reference hospital in cardiology were considered eligible. The patients were interviewed about their self-perceived stress through phone calls from August to December 2020. The clinical characteristics were obtained through the electronic record. The stress was evaluated using a Perceived Stress Scale – PSS-10. Those patients with a score higher than the PSS-10 average (16 points) were considered stressed. The patients were divided into groups with and without stress. The categorical variables were expressed through the frequency and percentage and analyzed by the chi-square test, and the continuous variables were described by average and standard deviation, then compared using a Student's t test. Results: A total of 501 patients were assessed for eligibility, and 200 were included. Forty-nine percent of the patients presented stress symptoms. The stressed patients were frequently younger and had a family history of premature coronary artery disease. The women were more often stressed than the men, even though both groups had a higher prevalence of stressed patients than non-stressed patients. Concerning the PSS-10 questions, the patients with stress were more frequently upset with something unexpected; they felt more often unable to control important matters in their lives, more nervous, and irritated than those without stress. They also referred to the greater difficulty they faced in controlling irritations in their lives. Finally, 50% of the stressed patients also felt very frequently that their problems had accumulated in such a manner that they could not solve them anymore, in comparison to 0.98% in the without-stress group. Conclusion: The patients with arterial coronary disease and self-perceived stress were younger and presented a family history of premature coronary disease. They had less control over their irritations and important issues in their lives, feeling overloaded and incapable of solving their problems compared to those without stress."