dc.contributor.author
Deter, Hans-Christian
dc.contributor.author
Meister, Reinhard
dc.contributor.author
Leineweber, Constanze
dc.contributor.author
Kecklund, Göran
dc.contributor.author
Lohse, Lukas
dc.contributor.author
Orth-Gomér, Kristina
dc.contributor.author
Fem-Cor-Risk Study group
dc.date.accessioned
2023-04-27T12:35:31Z
dc.date.available
2023-04-27T12:35:31Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/39143
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-38860
dc.description.abstract
Objective: The prognosis of coronary artery disease (CAD) is related to its severity and cardiovascular risk factors in both sexes. In women, social isolation, marital stress, sedentary lifestyle and depression predicted CAD progression and outcome within 3 to 5 years. We hypothesised that these behavioral factors would still be associated with all-cause mortality in female patients after 26 years.
Methods: We examined 292 patients with CAD and 300 healthy controls (mean age of 56 7 y) within the Fem-Cor-Risk-Study at baseline. Their cardiac, behavioral, and psychosocial risk profiles, exercise, smoking, and dietary habits were assessed using standardized procedures. Physiological characteristics included a full lipid profile, the coagulation cascade and autonomic dysfunction (heart rate variability, HRV). A new exploratory analysis using machine-learning algorithms compared the effects of social and behavioral mechanisms with standard risk factors. Results: All-cause mortality records were completed in 286 (97.9%) patients and 299 (99.7%) healthy women. During a median follow-up of 26 years, 158 (55.2%) patients and 101 (33.9%) matched healthy controls died. The annualized mortality rate was 2.1% and 1.3%, respectively. After controlling for all available confounders, behavioral predictors of survival in patients were social integration (HR 0.99, 95% CI 0.99-1.0) and physical activity (HR 0.54, 95% CI 0.37-0.79). Smoking acted as a predictor of all-cause mortality (HR 1.56, 95% CI 1.03-2.36). Among healthy women, moderate physical activity (HR 0.42, 95% CI 0.24-0.74) and complete HRV recordings (>= 50%) were found to be significant predictors of survival.
Conclusions: CAD patients with adequate social integration, who do not smoke and are physically active, have a favorable long-term prognosis. The exact survival times confirm that behavioral risk factors are associated with all-cause mortality in female CAD patients and healthy controls.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
coronary artery disease (CAD)
en
dc.subject
female patients after 26 years
en
dc.subject
behavioral factors
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Behavioral factors predict all-cause mortality in female coronary patients and healthy controls over 26 years – a prospective secondary analysis of the Stockholm Female Coronary Risk Study
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
e0277028
dcterms.bibliographicCitation.doi
10.1371/journal.pone.0277028
dcterms.bibliographicCitation.journaltitle
PLOS ONE
dcterms.bibliographicCitation.number
12
dcterms.bibliographicCitation.originalpublishername
Public Library of Science (PLoS)
dcterms.bibliographicCitation.volume
17
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
36477657
dcterms.isPartOf.eissn
1932-6203