Heart & lung : the journal of critical care · 2026
Stress before the event, care after: Psychosocial stressors, psychiatric care, and cardiac rehabilitation after early-onset myocardial infarction.
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Jurin Hrvoje, Jurin Ivana, Trbušić Matias, Poljak Tomislava Bodrožić Džakić, Gjuras Karlo, Skorić Ivan, Hadžibegović Irzal, Zeljković Ivan, Milić Sara, Rode Fran, Došen Denis, Pavlović Ana, Manola Šime, Bešić Kristina Marić, Krčmar Tomislav
Аннотация
BACKGROUND: Early-onset myocardial infarction (MI) has substantial consequences and sex-specific risk profiles. Psychosocial stressors and mental health may influence MI recovery.
OBJECTIVES: To examine sex differences in pre-MI psychosocial stressors, post-discharge mental health pathways, cardiac rehabilitation (CR), and 12-month secondary prevention.
METHODS: In this observational two-centre cohort (2021-2024), consecutive adults aged ≤45 years with confirmed MI and coronary angiography completed psychosocial questionnaires during hospitalisation; first-ever MI was not required. Telephone follow-up at 12 ± 3 months assessed mental health care, CR, LDL cholesterol, smoking, exercise, and psychiatric diagnoses.
RESULTS: Among 301 patients (214 men, 87 women; median age 43 years), 16 (5.3%) had prior MI. Women more often had MINOCA or SCAD and reported acute emotional stress before MI (58.6%vs 11.7%), serious family illness (18.4%vs 3.7%), and a child with special health care needs (20.7%vs 4.2%). Women had higher GAD-2 and PHQ-2 scores. Most patients reported no physician-initiated mental health discussion (78.4%), particularly men (82.9%vs 67.1%); women more often sought help (36.5%vs 16.1%). CR referral/attendance did not differ by sex. At follow-up, LDL decreased from 3.6 to 1.7 mmol/L and smoking from 78.5% to 46.8%.
CONCLUSION: Psychosocial stressors and psychological symptoms differed by sex, while clinician-initiated mental health discussions were uncommon. Findings are associative and hypothesis-generating, supporting psychosocial screening and referral pathways in cardiology follow-up and CR.
OBJECTIVES: To examine sex differences in pre-MI psychosocial stressors, post-discharge mental health pathways, cardiac rehabilitation (CR), and 12-month secondary prevention.
METHODS: In this observational two-centre cohort (2021-2024), consecutive adults aged ≤45 years with confirmed MI and coronary angiography completed psychosocial questionnaires during hospitalisation; first-ever MI was not required. Telephone follow-up at 12 ± 3 months assessed mental health care, CR, LDL cholesterol, smoking, exercise, and psychiatric diagnoses.
RESULTS: Among 301 patients (214 men, 87 women; median age 43 years), 16 (5.3%) had prior MI. Women more often had MINOCA or SCAD and reported acute emotional stress before MI (58.6%vs 11.7%), serious family illness (18.4%vs 3.7%), and a child with special health care needs (20.7%vs 4.2%). Women had higher GAD-2 and PHQ-2 scores. Most patients reported no physician-initiated mental health discussion (78.4%), particularly men (82.9%vs 67.1%); women more often sought help (36.5%vs 16.1%). CR referral/attendance did not differ by sex. At follow-up, LDL decreased from 3.6 to 1.7 mmol/L and smoking from 78.5% to 46.8%.
CONCLUSION: Psychosocial stressors and psychological symptoms differed by sex, while clinician-initiated mental health discussions were uncommon. Findings are associative and hypothesis-generating, supporting psychosocial screening and referral pathways in cardiology follow-up and CR.