Optimism and Gratitude Effects After Acute Coronary Syndrome

Study Questions:

Do optimism and gratitude affect physical activity, biomarkers, and readmissions after acute coronary syndrome (ACS)?

Methods:

The Gratitude Research in Acute Coronary Events Study included patients enrolled during admission for ACS between September 2012 and January 2014. Baseline assessment included Life Orientation Test-Revised, a measure of optimism, and the Gratitude Questionnaire-6 (GQ-6) for a measure of gratitude, which were completed at 2 weeks post-ACS. Additional measures included a measure of depression (the Patient Health Questionnaire-9) and anxiety (the seven-item Hospital Anxiety and Depression Scale anxiety subscale). Follow-up was through 6 months. Physical activity was measured primarily with accelerometry, controlling for baseline activity prior to ACS with a physical activity recall (PAR) questionnaire (the 7-day PAR). Biomarkers were measured as well, including C-reactive protein, interleukin-6 tumor necrosis factor-α, and soluble inter-cellular adhesion molecule-1).

Results:

A total of 164 patients who enrolled in the study and completed the baseline assessments at 2 weeks post-ACS were included in this analysis. Baseline optimism was significantly associated with greater physical activity at 6 months (n = 153; β = 102.5; 95% confidence interval, 13.6-191.5; p = 0.024), controlling for baseline activity and sociodemographic, medical, and negative psychological covariates. Baseline optimism was also associated with lower rates of cardiac readmissions at 6 months (n = 164), controlling for age, sex, and medical comorbidity (hazard ratio, 0.92; 95% confidence interval, 0.86-0.98; p = 0.006). There were no significant relationships between optimism and biomarkers. Gratitude was minimally associated with post-ACS outcomes.

Conclusions:

The investigators concluded that post-ACS optimism, but not gratitude, was prospectively and independently associated with superior physical activity and fewer cardiac readmissions.

Perspective:

As the investigators note, given these results, testing an intervention to promote optimism among ACS patients would be warranted.

Clinical Topics: Acute Coronary Syndromes, Diabetes and Cardiometabolic Disease, Prevention, ACS and Cardiac Biomarkers, Exercise

Keywords: Acute Coronary Syndrome, Anxiety Disorders, Biological Markers, Comorbidity, C-Reactive Protein, Exercise, Interleukin-6, Patient Readmission, Primary Prevention, Tumor Necrosis Factor-alpha


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