Transient stress cardiomyopathy (TSC) is detected in about 0.7-2.5% of patients admitted for acute coronary syndromes. Despite its low prevalence, TSC has attracted the attention of researchers due to its peculiar clinical characteristics, combining a clinical presentation similar to ST-elevation myocardial infarction (STEMI), the almost exclusive involvement of post-menopausal women and a usually benign prognosis. The physiopathology of TSC is still unknown and despite initial reports of a higher prevalence of previous depression and anxiety, the psychological profile of TSC patients is largely unexplored. The specific aims of this study are:1)To determine the long-term prognosis of women diagnosed with TSC compared to historical STEMI controls admitted to our institution. Hypothesis: Survival free of cardiovascular events will be greater in TSC women compared to STEMI.2)To examine the association of TSC with possible predisposing factors (i.e. previous mood and anxiety disorders or other psychiatric conditions; conditions associated with estrogen deficiency; emotional and physical triggers). Hypothesis: odds ratios of having a history of psychiatric disorders or conditions associated with estrogen deficiency will be higher in women with TSC compared to STEMI patients. 3)To evaluate the psychological and personality characteristics of women admitted with a new diagnosis of TSC compared to STEMI. Hypothesis: TSC women will have higher perceived stress as well as negative personality traits such as high hostility and low optimism compared to STEMI patients. For aim 1, we designed a retrospective cohort study in which survival free of cardiovascular events will be compared between 60 TSC women and 120 historical female controls with STEMI admitted to our institution from 1/1/2002 to 6/30/2012. Aim 2 will be addressed using a case-control design, where odd ratios of possible risk factors for TSC will be compared between 20 incident TSC female patients (cases) and 40 randomly selected incident STEMI female controls. For aim 3, questionnaires evaluating current psychological and personality characteristics will be completed by newly admitted TSC (n=20) and STEMI (n=40) women and characteristics will be compared between the two groups. This study will provide new information about largely unexplored predictors of TSC and inform the design of a future multicenter prospective cohort study in the same population.
|Program type||Mentored Clinical & Population Research Program|
|Effective start/end date||01/01/2013 → 12/31/2014|