Fear of recurrence consistent source of stress for heart attack survivors
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Key takeaways:
- Acute MI survivors reported continued fear of a recurrence 6 months and 8 months later.
- Perceived stress was independent of depression and anxiety symptoms.
CHICAGO — Survivors of an acute MI reported fear of a recurrence up to 8 months later, along with high levels of perceived stress that were distinct from depression and anxiety symptoms, researchers reported.
“Fear of recurrence is a significant mental health issue in post-heart attack survivors,” Sarah E. Zvonar, PhD, RN, CCRN, a postdoctoral researcher at Indiana University, told Healio. “Fear of recurrence was shown in this study to have a relationship with perceived stress. This study found that fear of recurrence and the relationship with perceived stress was still significant when holding depression and anxiety constant, meaning that this may be a different concept than depression and anxiety.”
Researchers analyzed data from 171 adults who survived an acute MI between 2021 and 2022, recruited primarily from Facebook advertisements. The mean age of participants was 39 years and 69% were women; 41% were white. Researchers directed respondents to a newly created Facebook group with links to the Brief Illness Perception Questionnaire, the Fear of Progression Questionnaire, the 10-item Perceived Stress Scale and the 21-item Depression Anxiety Stress Scale. Respondents completed the questionnaires twice, approximately 6 months and 8 months after their MI.
The findings were presented at the American Heart Association Scientific Sessions.
Within the cohort, 46.2% had hypertension, 44.4% had type 2 diabetes, 33% of participants reported using tobacco, 59% had low physical activity and mean alcohol intake was 1.35 drinks per week. Only 26% of respondents had attended at least one cardiac rehab session.
Researchers found that fear of recurrence was a significant mediator of the relationship between illness perceptions and perceived stress in acute MI survivors (P < .001).
Fear of recurrence did not decrease over time and was a significant mediator of illness perceptions and perceived stress even after controlling for depression and anxiety (P = .044).
In regression models, age and race were both predictors of fear of recurrence. Data also showed that alcoholic beverage intake was a predictor of fear of recurrence and perceived stress. The study was conducted during the COVID-19 pandemic, so researchers could not verify MI severity and medication use.
The researchers noted that the fear of recurrence and the relationships with illness perceptions and perceived stress suggest psychological sequelae may interfere with adaptive coping.
“Clinicians should be aware that this fear of having another heart attack may not mean that the patient is depressed or anxious and may not be identified on current tools to assess mental health after surviving an acute MI,” Zvonar told Healio. “Research should replicate this study in the more traditional acute MI population age range. A limitation of this study is that the sample median age was 39 years, and age was a significant predictor of fear of recurrence. This suggested that older survivors may not have a fear of recurrence as young survivors. Research should also identify if the fear of having another heart attack leads to mental health issues over time as well as coping with surviving a heart attack.”
Reference:
- Fear of another heart attack may be a major source of ongoing stress for survivors. https://newsroom.heart.org/news/fear-of-another-heart-attack-may-be-a-major-source-of-ongoing-stress-for-survivors. Published Nov. 11, 2024. Accessed Dec. 2, 2024.
For more information:
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Zvonar S, et al. Abstract MDP534. Presented at: American Heart Association Scientific Sessions; Nov. 16-18, 2024; Chicago.
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