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Perceived stress status and sympathetic nervous system activation in young male patients with coronary artery disease in China

  • Author Footnotes
    1 Contribute equally to this work.
    You Yang
    Footnotes
    1 Contribute equally to this work.
    Affiliations
    Department of Cardiology, The First People's Hospital of Shunde, Foshan, China
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  • Author Footnotes
    1 Contribute equally to this work.
    Minghui Bi
    Footnotes
    1 Contribute equally to this work.
    Affiliations
    Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China

    Department of Cardiology, Traditional Chinese Medicine Hospital at Xiamen, China
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  • Author Footnotes
    1 Contribute equally to this work.
    Lin Xiao
    Footnotes
    1 Contribute equally to this work.
    Affiliations
    Department of Internal medicine, The First People's Hospital of Shunde Affiliated Xingtan Hospital, Foshan, China
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  • Qiaopin Chen
    Affiliations
    Department of Psychology, The First People's Hospital of Shunde, Foshan, China
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  • Wenron Chen
    Affiliations
    Department of Internal medicine, The First People's Hospital of Shunde Affiliated Xingtan Hospital, Foshan, China
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  • Wensheng Li
    Affiliations
    Department of Cardiology, The First People's Hospital of Shunde, Foshan, China
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  • Yanxian Wu
    Affiliations
    Department of Cardiology, The First People's Hospital of Shunde, Foshan, China
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  • Yunzhao Hu
    Correspondence
    Corresponding authors at: Department of Cardiology, the First People's Hospital of Shunde, Penglai Road, Daliang Town, Shunde District, Foshan 528300, PR China. Tel.: +86 757 22318680 fax: +86 757 22223899.
    Affiliations
    Department of Cardiology, The First People's Hospital of Shunde, Foshan, China
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  • Yuli Huang
    Correspondence
    Corresponding authors at: Department of Cardiology, the First People's Hospital of Shunde, Penglai Road, Daliang Town, Shunde District, Foshan 528300, PR China. Tel.: +86 757 22318680 fax: +86 757 22223899.
    Affiliations
    Department of Cardiology, The First People's Hospital of Shunde, Foshan, China
    Search for articles by this author
  • Author Footnotes
    1 Contribute equally to this work.
Published:August 18, 2015DOI:https://doi.org/10.1016/j.ejim.2015.08.005

      Highlights

      • The incidence of coronary artery disease in younger subjects is increasing in China.
      • Young adults, especially males, have faced increasing psychological stress in China.
      • Perceived stress is associated with activation of the sympathetic nervous system.
      • Perceived stress is a risk factor for coronary artery disease in young Chinese males.

      Abstract

      Background and purpose

      Young Chinese male adults have faced increasing psychological stress. Whether this is associated with the increased risk of coronary artery disease (CAD) in young Chinese males remains unclear. This study aimed to evaluate the correlation and underlying mechanisms of perceived stress and CAD in young male patients.

      Methods

      A total of 178 male patients diagnosed as young CAD (aged ≤55 years) by coronary angiography (CAG) were enrolled, and 181 age-matched non-CAD individuals were set as control group. Traditional cardiovascular risk factors and levels of epinephrine and norepinephrine were measured, and perceived stress status was accessed by Perceived Stress Scale (PSS).

      Results

      The PSS score was correlated with levels of epinephrine (r = 0.45), norepinephrine (r = 0.41), high-sensitivity C-reactive protein (hs-CRP) (r = 0.38, p < 0.01), and current smoking (r = 0.32) (all p < 0.05). Multivariate logistic regression analysis showed that smoking (OR, 3.12; 95%CI, 1.23–7.91), triglycerides (OR, 1.42; 95%CI, 1.04–1.94), hs-CRP (OR, 3.57; 95%CI, 1.65–7.72), and PSS score (OR, 1.81; 95%CI, 1.23–2.66) were independently correlated with CAD in young patients. The association between PSS score and risk of CAD become insignificant (OR, 1.43; 95%CI, 0.96–2.13) when further adjusted for the levels of epinephrine and norepinephrine.

      Conclusions

      After adjustment for multiple cardiovascular risk factors, high perceived stress was an independent risk factor for CAD in young Chinese male patients. Abnormal activation of the sympathetic nervous system may play an important role linking perceived stress with the risk of CAD.

      Keywords

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