Impact of hostility on mortality of patients with coronary artery disease after percutaneous coronary intervention

Aim. The study focuses on the assessment of associations of hostility with clinical and instrumental variables in patients with coronary artery disease after percutaneous coronary intervention, as well as on its effect on the risk of death for the patients in one year after surgery. Methods. The prospective study included 1,018 patients with coronary artery disease (764 men and 254 women, mean age 58.9±9.7 years) who had undergone percutaneous coronary intervention. Mean duration of follow-up was 12.0±1.8 months. Hostility was assessed by Russian version of Cook and Medley hostility scale. To investigate the relative risk (RR) of death from all causes and cardiovascular disease was used Cox's multivariate regression model of proportional risk. Results. The mean score on the Cook-Medley hostility scale was 15.1 ±3.9. A high level of hostility was observed in 189 patients (20.0%). There was no difference in age, gender and main clinical and instrumental variables between reference group and group of patients with a high level of hostility. No difference was found in echocardiographic parameters and coronary angiographic data between the groups. At admission, acute coronary syndrome was more often observed in patients with a high level of hostility as compared to those in the reference group (39.2% vs. 31.0%, p = 0.03). During the follow-up, 24 patients (2.4%) died from all causes and 21 patients (2.2%) died from cardiovascular disease. Depending on the level of hostility, RR of death from all causes was 1.10 (95% confidence interval [CI] 0.99-1.22, p = 0.09) and 1.12 (95% CI 1.01-1.27, p = 0.04) from cardiac causes. When analyzing categorical indicators, in patients with a high level of hostility, the relative risk of death, both for all causes (RR = 2.65, 95% CI 1.09-6.45, p = 0.03) and cardiovascular disease (RR = 3.38, 95% CI 1.29-8.82, p = 0.01), was significantly higher in comparison with patients in the reference group. Conclusion. Acute coronary syndrome was more frequently diagnosed in patients with a high level of hostility. The hostility was significantly and independently associated with the risk of death from cardiovascular disease in patients with coronary artery disease after percutaneous coronary interventions. In patients with high levels of hostility, the risk of all-cause and cardiovascular mortality was significantly higher.