Abstract
Psychosocial stress at work is a risk factor for cerebro- and cardiovascular event (CVE) such as stroke or acute myocardial infarction (MI). However, data on psychosocial factors (PSF) profile in patients with CVE are scarce. In a multidisciplinary approach, we aimed to characterize PSF burden in patients with acute stroke or MI. In a prospective pilot study, 45 patients aged < 60 years, currently working and hospitalized for stroke or MI were included. Risk scores (GRACE, Charlson) were examined across categories of PSF (perceived disease severity, anxiety/depression, stress at work, quality of life at work). Among the 44 patients included, 77% had acute MI and 23% stroke. Mean age was 50 years, 77% were male, 43% were current smokers, 39% had hypertension, 41% hypercholesterolemia and 36% obesity. Education level was at 4,65 (secondary education), and most (41%) had low socioprofessional status. Mean levels of PSF were: perceived disease severity (4.5/5), anxiety/depression (0.91/4), stress at work (2.75/5), quality of life at work (3.67/5). GRACE and Charlson risk scores were at 6 and 93, respectively. Severity of the disease perceived by the patient was correlated positively with the stress experienced before CVE ( r = 0.20, P < 0.07) and with the patient's current anxiety ( r = 0.20, P < 0.07) and negatively with the quality of life at work experienced before the CVE ( r = 0.11, P < 0.10). Comorbidity score (Charlson) was not correlated with the perceived severity of the disease ( r = −0.06, P < 0.28). Moreover, GRACE score showed a trend toward a correlation with the stress felt before MI ( r = −0.19, P < 0.28). These preliminary data from a prospective pilot study in young patients with acute CVE shows a high PSF burden and suggest for the first time the disconnection between perceived and true severity disease. If confirmed at a larger scale, our data could identify new opportunities for preventive strategies.
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