OBJECTIVES: Studies investigating the prognostic role of job stress in coronary heart disease are sparse and have inconclusive findings. We aimed (i) to investigate whether job strain predicts recurrent events after acute myocardial infarction (AMI) and if so (ii) to determine behavioural and biological factors that contribute to the explanation of this association. DESIGN: Prospective study. SETTING: Ten emergency hospitals in the larger Stockholm area, Sweden. SUBJECTS: Non-fatal AMI cases from the Stockholm Heart Epidemiology Program case-control study who were employed and younger than 65 years at the time of their hospitalization (n = 676). RESULTS: During the 8.5 year follow-up, 155 patients experienced cardiac death or non-fatal AMI; totally 96 patients died, 52 of cardiac causes. After adjustment for potential confounders, patients with high job strain had an increased risk for the combination of cardiac death and non-fatal AMI relative to those with low job strain, the hazard ratio (HR) and the 95% confidence interval (CI) being 1.73 (1.06-2.83). Results were similar for cardiac [HR (95% CI): 2.81 (1.16-6.82)] and total mortality [HR (95% CI): 1.65 (0.91-2.98)]. We found no evidence for mediation from lifestyle, sleep, lipids, glucose, inflammatory and coagulation markers on the association between job strain and the combination of cardiac death and non-fatal AMI. CONCLUSIONS: Job strain was associated with poor long-term prognosis after a first myocardial infarction. Interventions focusing on reducing stressors at the workplace or on improving coping with work stress in cardiac patients might improve their survival post-AMI.
OBJECTIVES: Studies investigating the prognostic role of job stress in coronary heart disease are sparse and have inconclusive findings. We aimed (i) to investigate whether job strain predicts recurrent events after acute myocardial infarction (AMI) and if so (ii) to determine behavioural and biological factors that contribute to the explanation of this association. DESIGN: Prospective study. SETTING: Ten emergency hospitals in the larger Stockholm area, Sweden. SUBJECTS: Non-fatal AMI cases from the Stockholm Heart Epidemiology Program case-control study who were employed and younger than 65 years at the time of their hospitalization (n = 676). RESULTS: During the 8.5 year follow-up, 155 patients experienced cardiac death or non-fatal AMI; totally 96 patients died, 52 of cardiac causes. After adjustment for potential confounders, patients with high job strain had an increased risk for the combination of cardiac death and non-fatal AMI relative to those with low job strain, the hazard ratio (HR) and the 95% confidence interval (CI) being 1.73 (1.06-2.83). Results were similar for cardiac [HR (95% CI): 2.81 (1.16-6.82)] and total mortality [HR (95% CI): 1.65 (0.91-2.98)]. We found no evidence for mediation from lifestyle, sleep, lipids, glucose, inflammatory and coagulation markers on the association between job strain and the combination of cardiac death and non-fatal AMI. CONCLUSIONS: Job strain was associated with poor long-term prognosis after a first myocardial infarction. Interventions focusing on reducing stressors at the workplace or on improving coping with work stress in cardiac patients might improve their survival post-AMI.
Authors: Eleonor I Fransson; Solja T Nyberg; Katriina Heikkilä; Lars Alfredsson; De Dirk Bacquer; G David Batty; Sébastien Bonenfant; Annalisa Casini; Els Clays; Marcel Goldberg; France Kittel; Markku Koskenvuo; Anders Knutsson; Constanze Leineweber; Linda L Magnusson Hanson; Maria Nordin; Archana Singh-Manoux; Sakari Suominen; Jussi Vahtera; Peter Westerholm; Hugo Westerlund; Marie Zins; Töres Theorell; Mika Kivimäki Journal: BMC Public Health Date: 2012-01-20 Impact factor: 3.295
Authors: Jaskanwal D Sara; Megha Prasad; Mackram F Eleid; Ming Zhang; R Jay Widmer; Amir Lerman Journal: J Am Heart Assoc Date: 2018-04-27 Impact factor: 5.501