With little known regarding psychological distress and residual risk of future cardiovascular events in young and middle-aged patients with a recent myocardial infarction (MI), researchers divided patients aged 18-61 with an MI in the previous 8 months into tertiles of mild, moderate, or high distress based on composite psychological distress scores. Patients with high distress were more likely to be Black, female, and socioeconomically disadvantaged (low education and income, unemployed) and to have diabetes, hypertension, or a smoking history. Major adverse cardiovascular events were experienced by 37% of those in the high distress group, compared with 17% in the mild distress group, equating to a 2.7-fold increased risk of MACE during 5 years of follow-up for the high distress group. The increased risk was similar (2.5-fold) after adjusting for age, sex, race, and education, but it was attenuated after further adjustment for BMI, smoking, hypertension, diabetes, dyslipidemia, and medications (hazard ratio, 1.9) and was no longer significant after even further adjustment for interleukin-6 and monocyte chemoattractant protein-1 (HR, 1.5).
