{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T23:10:00Z","timestamp":1784934600675,"version":"3.55.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,5,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Higher symptom levels of a variety of measures of emotional distress have been associated with cardiovascular disease (\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              ), especially among women. Here, our goal was to investigate the association between a composite measure of psychological distress and incident cardiovascular events.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In a prospective cohort study, we assessed 662 individuals (28% women; 30% blacks) with stable coronary artery disease. We used a composite score of psychological distress derived through summation of Z\u2010transformed psychological distress symptom scales (depression, posttraumatic stress, anxiety, anger, hostility, and perceived stress) as a predictor of an adjudicated composite end point of adverse events (cardiovascular death, myocardial infarction, stroke, heart failure, or unstable angina). During a mean follow\u2010up of 2.8\u00a0years, 120 (18%) subjects developed\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              events. In the overall population, there was no association between the psychological distress measure and\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              events, but there was a sex\u2010based interaction (\n              <jats:italic>P<\/jats:italic>\n              =0.004). In women, higher psychological distress was associated with a higher incidence of\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              events; each SD increase in the composite score of psychological distress was associated with 1.44 times adjusted hazard of\n              <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n              events (95% CI, 1.09\u20131.92). No such association was found in men.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Among patients with coronary artery disease, higher psychological distress is associated with future cardiovascular events in women only.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.011866","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T14:46:36Z","timestamp":1557153996000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":95,"title":["Psychological Distress and Subsequent Cardiovascular Events in Individuals With Coronary Artery Disease"],"prefix":"10.1161","volume":"8","author":[{"given":"Pratik","family":"Pimple","sequence":"first","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno B.","family":"Lima","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Hammadah","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kobina","family":"Wilmot","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronnie","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleksiy","family":"Levantsevych","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samaah","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belal","family":"Kaseer","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit J.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA"},{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; Bioinformatics Rollins School of Public Health Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Raggi","sequence":"additional","affiliation":[{"name":"Mazankowski Alberta Heart Institute University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Douglas","family":"Bremner","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Emory University School of Medicine Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Hanfelt","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; Bioinformatics Rollins School of Public Health Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tene","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arshed A.","family":"Quyyumi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola","family":"Vaccarino","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA"},{"name":"Division of Cardiology Department of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.617"},{"key":"e_1_3_1_3_2","unstructured":"National Institute of Mental Health (NIMH) . Mental health information. Bethesda MD: NIMH; 2013."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2003.09.001"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000019"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2016.181"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.07.031"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.156554"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.11.044"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.08.004"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.131.2.260"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.018926"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.04.023"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000000442"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)30377-7"},{"key":"e_1_3_1_16_2","volume-title":"BDI\u2010II. Beck Depression Inventory","author":"Beck AT","year":"1996","unstructured":"Beck AT, Steer RA, Brown GK. BDI\u2010II. Beck Depression Inventory. 2nd ed. San Antonio, TX: The Psychological Corporation; 1996.","edition":"2"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e3182405ac4"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(96)00033-2"},{"key":"e_1_3_1_19_2","volume-title":"State\u2010Trait Anxiety (STAI) Manual","author":"Spielberger CD","year":"1970","unstructured":"Spielberger CD, Gorsuch RL, Lushene RE. State\u2010Trait Anxiety (STAI) Manual. Palo Alto, CA: Consulting Psychologists Press; 1970."},{"key":"e_1_3_1_20_2","volume-title":"Professional Manual for the State\u2010Trait Anger Expression Inventory","author":"Spielberger CD","year":"1988","unstructured":"Spielberger CD. Professional Manual for the State\u2010Trait Anger Expression Inventory. Research ed. Tampa, FL: University of South Florida; 1988."},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1037\/h0060667"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.2307\/2136404"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/psy.0000000000000674"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511499531"},{"key":"e_1_3_1_25_2","volume-title":"Latent Class and Latent Transition Analysis: With Applications in the Social, Behavioral, and Health Sciences","author":"Collins LM","year":"2013","unstructured":"Collins LM, Lanza ST. Latent Class and Latent Transition Analysis: With Applications in the Social, Behavioral, and Health Sciences. Hoboken, New Jersey: John Wiley & Sons; 2013."},{"key":"e_1_3_1_26_2","volume-title":"Technical Guide for Latent Gold 5.0: Basic, Advanced, and Syntax","author":"Vermunt JK","year":"2013","unstructured":"Vermunt JK, Magidson J. Technical Guide for Latent Gold 5.0: Basic, Advanced, and Syntax. Belmont, MA: Statistical Innovations; 2013."},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.190769"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-014-0371-z"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.125"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.05.008"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17018-9"},{"key":"e_1_3_1_32_2","first-page":"1879","volume-title":"Braunwald's heart disease \u2010 a textbook of cardiovascular medicine, 11th ed","author":"Vaccarino V","year":"2019","unstructured":"Vaccarino V, Bremner JD. Psychiatric and behavioral aspects of cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, eds. Braunwald's heart disease \u2010 a textbook of cardiovascular medicine, 11th ed. Philadelphia, PA: Elsevier\u2010Saunders; 2019:1879\u20131889."},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2015.08.008"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.087"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e318160686a"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11199-005-6762-3"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000131"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2017.09.008"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.118.011866","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:36:27Z","timestamp":1715600187000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.118.011866"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,7]]},"references-count":37,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2019,5,7]]}},"alternative-id":["10.1161\/JAHA.118.011866"],"URL":"https:\/\/doi.org\/10.1161\/jaha.118.011866","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,7]]},"assertion":[{"value":"2018-12-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e011866"}}