Type A behavior and angiographically documented coronary atherosclerosis in a sample of 2,289 patients.
Type A behavior and angiographically documented coronary atherosclerosis in a sample of 2,289 patients.
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2,289 名患者样本中的 A 型行为和血管造影记录的冠状动脉粥样硬化。
DOI：
10.1097/00006842-198803000-00004
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发表时间：
1988
影响因子：
3.3
通讯作者：
Peterson,B
中科院分区：
文献类型：
--
作者：
WilliamsJr,RB;Barefoot,JC;Haney,TL;HarrellJr,FE;Blumenthal,JA;Pryor,DB;Peterson,B
为了确定A型行为模式与冠状动脉造影证实的冠状动脉粥样硬化(CAD)之间的关系，我们分析了1974年至1980年在杜克大学医学中心接受诊断冠状动脉造影术的2289名患者的危险因素、行为和血管造影数据。多因素有序Logistic回归分析显示，在控制了年龄、性别、高脂血症、吸烟、高血压等多种显著交互作用后，结构化访谈(SI)评估的A型行为与冠心病的严重程度显著相关。然而，这种关系取决于年龄。在45岁或以下的患者中，A型的冠心病比B型的严重；在46-54岁的患者中，A型和B型的冠心病严重程度相似；在55岁及以上的患者中，B型的冠心病有比A型更严重的趋势。这些A型-CAD关系似乎不是与选择患者进行血管造影有关的各种因素的结果。Jenkins活动调查评估的A型行为与冠心病严重程度无关。这些发现表明，在接受诊断冠状动脉造影术的年轻患者中，SI决定的A型行为与更严重的冠心病有关。老年患者A型-CAD关系的逆转可能是由于生存影响。样本量不足，使用SI以外的评估工具，以及未能考虑A型与年龄的交互作用，可能是在其他研究中未能找到A型-CAD关系的原因。我们的结论是，目前的发现与A型行为与CAD发病有关的假设是一致的，但仅在较年轻的年龄组。然而，与吸烟和高脂血症相比，目前数据中的A型影响较小，未来的研究应该更具体地关注A型行为中的敌意和愤怒成分，特别是在更年轻的样本中。
To determine the relationship between Type A behavior pattern and angiographically documented coronary atherosclerosis (CAD), we analyzed risk factor, behavioral, and angiographic data collected on 2,289 patients undergoing diagnostic coronary angiography at Duke University Medical Center between 1974 and 1980. Multivariable analyses using ordinal logistic regression techniques showed that Type A behavior as assessed by the structured interview (SI) is significantly associated with CAD severity after age, sex, hyperlipidemia, smoking, hypertension, and their various significant interactions were controlled for. This relationship, however, is dependent upon age. Among patients aged 45 or younger, Type A's had more severe CAD than did Type B's; among patients aged 46–54, CAD severity was similar between Type A's and B's; and among patients 55 and older, there was a trend toward more severe CAD among Type B's than among Type A's. These Type A-CAD relationships did not appear to be the result of various factors relating to the selection of patients for angiography. Type A behavior as assessed by the Jenkins Activity Survey was unrelated to CAD severity. These findings suggest that SI-determined Type A behavior is associated with more severe CAD among younger patients referred for diagnostic coronary angiography. The reversal of the Type A-CAD relationship among older patients may be due to survival effects. Inadequate sample sizes, use of assessment tools other than the SI, and failure to consider the Type A by age interaction could account for failures to find a Type A-CAD relationship in other studies. We conclude that the present findings are consistent with the hypothesis that Type A behavior is involved in the pathogenesis of CAD, but only in younger age groups. The Type A effect in the present data is small relative to that of both smoking and hyperlipidemia, however, and future research should focus more specifically on the hostility and anger components of Type A behavior, particularly in younger samples.
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A 型行为、自我参与和冠状动脉粥样硬化
影响因子：
3.3
作者：
L. Scherwitz;R. McKelvain;C. Laman;J. Patterson;L. Dutton;S. Yusim;J. Lester;I. Kraft;D. Rochelle;R. Leachman
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影响因子：
3.3
作者：
B. Schucker;D. Jacobs
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DOI：
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发表时间：
1988
期刊：
影响因子：
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作者：
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通讯作者：
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阿司匹林心肌梗塞研究中的 A 型评分（詹金斯活动调查）和复发冠心病的风险。
DOI：
10.1016/0002-9149(85)90838-0
发表时间：
1985
期刊：
The American journal of cardiology
影响因子：
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作者：
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影响因子：
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S. Zyzanski;C. D. Jenkins;T. Ryan;A. Flessas;M. Everist
通讯作者：
M. Everist