Chronic stress exposure in men and women, and implications for the course of fatigue after percutaneous coronary intervention: The THORESCI study

Fleur Doedee, Sophie Van Den Houdt, Jos Widdershoven, Nina Kupper*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

Background
Fatigue is a prevalent symptom in patients with coronary heart disease (CHD). Individual differences in chronic stress may affect the experience and persistence of fatigue, and this may vary between the sexes. Therefore, we studied the effect of chronic stress on the course of fatigue over a 2-year period after percutaneous coronary intervention (PCI), and examined the moderating effects of sex.

Methods
1682 patients (78% men, age = 67.1 ± 10.6) were recruited and filled out multiple self-report questionnaires at baseline, one, 12, and 24 months post-PCI, including questions on demographics, fatigue (HCS). Multiple chronic stressors were assessed at baseline: work stress (ERI16), marital stress (MMQ-6), early life events (Life Events Questionnaire) and social stress. Latent class factor analysis (LatentGOLD) was used to construct a comprehensive chronic stress index. Linear mixed modeling examined the predictive quality of predictors and covariates.

Results
Fatigue was found to substantially decrease over the first month post-PCI, then stabilized at a moderate level. Chronic stress impacted both the level and course of fatigue by increasing its level and delaying recovery. Overall and across time, women reported more fatigue than men. The level and course effects of chronic stress and sex were independent of demographic, health behavioral, and medical covariates.

Conclusions
Individual differences in chronic stress impact both the level and course of fatigue post-PCI, with women being affected most. Future research could further explain the mechanisms underlying the observed relationships. Developing and testing interventions focusing on exercise and stress-reduction could be used to alleviate fatigue.
Original languageEnglish
Pages (from-to)45-52
JournalGeneral Hospital Psychiatry: Psychiatry, Medicine and Primary Care
Volume72
DOIs
Publication statusPublished - 2021

Keywords

  • acute coronary syndrome
  • chronic stress
  • myocardial infarction
  • recovery
  • stable angina

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