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Relationship Psychosocial Factors And Mortality In Open Heart

Armen Hareyan's picture

Coronary artery bypass grafting (CABG, often called "cabbage") is the most commonly performed open heart operation in the United States.The surgery reroutes, or "bypasses," blood around clogged arteries to improve blood flow and oxygen to the heart.

A Cleveland Clinic Preventive Cardiology & Rehabilitation study, in collaboration with the Bakken Heart-Brain Institute, examined four psychosocial characteristics of patients prior to CABG surgery. Patients filled out a questionnaire assessing the existence of life stress, time pressure, anger, or sadness prior to CABG surgery. The study examined the existence of the four factors and the predictive value of these variables on post-operative mortality.

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The study, led by Dr. Leo Pozuelo, showed that patients who reported the presence of life stress and time urgency prior to CABG surgery tended to have a protective effect in follow-up mortality, or they had better outcomes. The findings may validate the characteristics of the "Type A" personality as not being detrimental to coronary artery disease patients. The presence of anger did not have an effect on post-operative mortality. The presence of sadness appeared to have an early detrimental effect on mortality.

"It has been known for many years that psychosocial characteristics have an effect on health," said Leo Pozuelo, M.D., primary investigator and Director of the Cardiovascular Behavioral Health Clinic, Cleveland Clinic. "Our findings suggest that pre-operative screening and possible intervention for psychosocial characteristics, such as sadness, may improve patient outcomes."

About the Study

Using the Precis Database, 4166 patients admitted to the Cleveland Clinic for CABG, from March 2000 through Sept. 2006 were studied. The mean age was 66.5 and 76 % were men. All patients completed a questionnaire about the presence of the four psychosocial variables prior to admission. Patient mortality, measured up to 6 years after the CABG, was assessed via the Social Security Death Index. Survival was compared amongst subjects with the history or no history of the psychosocial variables.