Psychological Characteristics and Social Integration of Patients with Ischemic and Non‐Ischemic Heart Failure Newly Listed for Heart Transplantation: The Waiting for a New Heart Study

Abstract

It is not known whether psychosocial risk factors for coronary artery disease (CAD) are present in patients listed for heart transplantation (HTx). The aim of this study was to examine whether HTx candidates with ischemic heart failure (due to CAD) have an adverse psychological risk profile and reduced social integration compared to patients with non‐ischemic etiology. In the multi‐site study “Waiting for a New Heart”, waiting‐list‐related stressors, depression, anxiety, trait‐anger, anger‐expression, dispositional coping, social integration, and social support were assessed in 318 newly registered HTx candidates (53.5 ± 11.4 years, 18% female, left ventricular ejection fraction <25%). Medical parameters at time of listing were provided by Eurotransplant. Analyses revealed a high level of stress (on average 70% of 50 HTx‐related stressors), and signs of clinical depression in 39 per cent of the sample. Social integration was correlated with reduced depression (p < .05). While ischemic and non‐ischemic groups were comparable in terms of disease severity, men with CAD reported significantly more anxiety, anger, anger‐in, and less social integration than non‐ischemic men after adjusting for age and marital status (ps < .05). To conclude, psychosocial stress is common in HTx candidates, particularly in men with underlying CAD. Thus, targeting psychosocial stress and increasing social integration may enhance well‐being in patients waiting for a new heart.