Psychological coping and recurrent major adverse cardiac events following acute coronary syndrome.

Abstract

Depressed mood and stress are associated with recurrent adverse outcomes following acute coronary syndrome (ACS), but the impact of psychological coping style has not been evaluated in detail. We tested the relationship between task-oriented coping and event-free survival following ACS. We followed 158 patients with ACS for an average of 59.8 months for major adverse cardiac outcomes. Psychological coping was assessed with the Coping Inventory of Stressful Situations. Compared with patients in the lower half of the distribution, those reporting higher task-oriented coping had a reduced hazard of adverse cardiac events (hazard ratio (HR) = 0.28, 95% CI 0.11-0.68, P = 0.005) independently of demographic, clinical and behavioural covariates. The combination of low task-oriented coping and high depressive symptoms showed a strong association with adverse outcomes (HR = 6.25, 95% CI 1.88-20.82, P = 0.003). The tendency to cope using task-oriented strategies may promote event-free survival following ACS.