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Clinical and Lifestyle Predictors of Progression of Angiographic Coronary Artery Disease
Results: In total, 12,142 subjects (54% male and mean age 48 ± 15 years) were screened: 11% were obese (BMI 25 ± 4.0 kg/m2 ), 13% were active smokers, 35% had hypertension (systolic/diastolic BP 133 ± 20.3/83 ± 11.3 mm/Hg) and 43% were dyslipidaemic (total cholesterol: 5.3 ± 1.1 mmol/L). The proportion of subjects with one or multiple risk factors was 37% and 29% (66% combined), respectively. There were significant changes in some risk factors over time (adjusted OR for 1987–1991 versus 2002–2006 cohorts). Adjusting for age and sex, subjects presenting with hypertension (28% versus 49%; OR 1.64; 95% CI 1.44–1.87) and obesity (9.6% versus 27%; OR 2.59; 95% CI 2.21–3.04) rose significantly over time. Alternatively, there was no relative change in those presenting with dyslipidaemia (42% versus 51%: OR 1.01; 95% CI 0.89–1.14) or as active smokers (15% versus 12%; OR 1.05; 95% CI 0.88–1.26) over the same period. Conclusion: The risk factor profile of attendees at the Baker Risk Clinic is changing over time and is reflective of current health trends in the Australian population. doi:10.1016/j.hlc.2008.05.497 497 Simple Adjectives Can Measure Perceived Social Support and its Relationship to Both Anxiety and Depression Andrew Stewart 1,∗ , David Hare 2 1 University of Melbourne, Melbourne, Australia; 2 University of Melbourne, Austin Hospital, Melbourne, Australia
Objective: Depression, anxiety and perceived social support have associations with quality of life and prognosis for chronic heart failure (CHF) patients. These constructs are often measured with separate questionnaires without consideration of questionnaire and construct overlap. We developed an adjective rating scale to simultaneously measure mood, anxiety, perceived support (security) and perceived isolation (insecurity). Clear distinction between constructs is important in light of recent research finding that adverse close relationships were associated with incident coronary events whereas perceived emotional support was not. Method: A pool of 48 items was developed with 12 adjectives for each construct. A total of 278 CHF out-patients were asked to indicate the extent to which they had felt each emotion in the past month with responses from “Not at all” (0) to “Extremely” (5). Factor analysis of the items was conducted with maximum likelihood extraction and oblique rotation. Items were selected on the basis of the magnitude of their factor loading and absence of cross loadings with other items. Results: Four independent scales were identified with seven items per scale: depression (e.g. down, blue, miserable); anxiety (e.g. frightened, scared, nervous); secure (cared for, supported, protected) and insecure (forgotten, rejected, left out). Each scale demonstrated high internal consistency with Cronbach’s α ranging from 0.89 to 0.93. Conclusion: This scale provides a simple method to measure multiple constructs. The scale has utility for inpatient
Abstracts
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settings where traditional measures of mood and perceived care refer to activities that are not relevant to an inpatient. doi:10.1016/j.hlc.2008.05.498 498 Clinical and Lifestyle Predictors of Progression of Angiographic Coronary Artery Disease Daniel Sathianathan ∗ , Ahmad Farshid, Charles T. Itty, Lynette Divorty, Michelle McAlpin, Jenny Coutts Canberra Hospital, Canberra, ACT, Australia Multiple clinical and lifestyle factors have been associated with the incidence of coronary artery disease. The importance of these factors in progression of angiographic coronary artery disease has not been well studied. Our study involves comparing serial coronary angiograms of patients and correlating clinical and lifestyle factors with disease progression. Patients undergoing repeat coronary angiography since 2000 at our institution were recruited. Clinical characteristics, height, weight, waist and hip circumference were recorded. A dietary and lifestyle questionnaire was administered. Coronary arteries were divided into 15 segments and each segment was given separate scores for disease severity and extent. Results for the first 18 patients are as follows. Mean age was 69.7 years and 78% were males. There was an average of 4.75 years between the two angiograms. 83% of patients had hypertension and 28% had diabetes. Average weight was 82.6 kg and average BMI was 28.4. Average waist was 103 cm. On average, subjects exercised twice per week. They reported eating 7 servings of fruit, 10 servings of vegetables, 5 servings of meat and 1 serving of fish per week. Progression of coronary artery disease was documented in 67% of subjects. In those with progression, the extent of disease increased by a mean of 5.3% and severity of disease by 6.3%. Trends towards greater progression were observed in patients with diabetes and hypertension. For example, mean extent score increase for diabetics was 0.19 ± 0.14 versus 0.07 ± 0.03 for non diabetics (p = 0.037). Patients with more diffuse disease on the initial angiogram also tended to have more progression (p = 0.052). It is expected that complete data on 100 patients will be available by August 2008. doi:10.1016/j.hlc.2008.05.499
ABSTRACTS
Heart, Lung and Circulation 2008;17S:S1–S209
Objective: Depression, anxiety and perceived social support have associations with quality of life and prognosis for chronic heart failure (CHF) patients. These constructs are often measured with separate questionnaires without consideration of questionnaire and construct overlap. We developed an adjective rating scale to simultaneously measure mood, anxiety, perceived support (security) and perceived isolation (insecurity). Clear distinction between constructs is important in light of recent research finding that adverse close relationships were associated with incident coronary events whereas perceived emotional support was not. Method: A pool of 48 items was developed with 12 adjectives for each construct. A total of 278 CHF out-patients were asked to indicate the extent to which they had felt each emotion in the past month with responses from “Not at all” (0) to “Extremely” (5). Factor analysis of the items was conducted with maximum likelihood extraction and oblique rotation. Items were selected on the basis of the magnitude of their factor loading and absence of cross loadings with other items. Results: Four independent scales were identified with seven items per scale: depression (e.g. down, blue, miserable); anxiety (e.g. frightened, scared, nervous); secure (cared for, supported, protected) and insecure (forgotten, rejected, left out). Each scale demonstrated high internal consistency with Cronbach’s α ranging from 0.89 to 0.93. Conclusion: This scale provides a simple method to measure multiple constructs. The scale has utility for inpatient
Abstracts
S209
settings where traditional measures of mood and perceived care refer to activities that are not relevant to an inpatient. doi:10.1016/j.hlc.2008.05.498 498 Clinical and Lifestyle Predictors of Progression of Angiographic Coronary Artery Disease Daniel Sathianathan ∗ , Ahmad Farshid, Charles T. Itty, Lynette Divorty, Michelle McAlpin, Jenny Coutts Canberra Hospital, Canberra, ACT, Australia Multiple clinical and lifestyle factors have been associated with the incidence of coronary artery disease. The importance of these factors in progression of angiographic coronary artery disease has not been well studied. Our study involves comparing serial coronary angiograms of patients and correlating clinical and lifestyle factors with disease progression. Patients undergoing repeat coronary angiography since 2000 at our institution were recruited. Clinical characteristics, height, weight, waist and hip circumference were recorded. A dietary and lifestyle questionnaire was administered. Coronary arteries were divided into 15 segments and each segment was given separate scores for disease severity and extent. Results for the first 18 patients are as follows. Mean age was 69.7 years and 78% were males. There was an average of 4.75 years between the two angiograms. 83% of patients had hypertension and 28% had diabetes. Average weight was 82.6 kg and average BMI was 28.4. Average waist was 103 cm. On average, subjects exercised twice per week. They reported eating 7 servings of fruit, 10 servings of vegetables, 5 servings of meat and 1 serving of fish per week. Progression of coronary artery disease was documented in 67% of subjects. In those with progression, the extent of disease increased by a mean of 5.3% and severity of disease by 6.3%. Trends towards greater progression were observed in patients with diabetes and hypertension. For example, mean extent score increase for diabetics was 0.19 ± 0.14 versus 0.07 ± 0.03 for non diabetics (p = 0.037). Patients with more diffuse disease on the initial angiogram also tended to have more progression (p = 0.052). It is expected that complete data on 100 patients will be available by August 2008. doi:10.1016/j.hlc.2008.05.499
ABSTRACTS
Heart, Lung and Circulation 2008;17S:S1–S209