Type A Behavior Pattern and Coronary Atherosclerosis
Type A Behavior Pattern and Coronary Atherosclerosis
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A 型行为模式与冠状动脉粥样硬化
作者：
J. Blumenthal;R. Williams;Y. Kong;S. Schanberg;L. Thompson
总结以前的研究已经证明，在表现出“冠状动脉倾向”（A型）行为模式的人群中，临床冠心病（CHD）事件的发生率增加。本研究旨在确定A型行为模式与冠心病之间的关联是否可能超出临床冠心病事件，也包括冠状动脉粥样硬化过程。除常规临床评价外，156例连续转诊进行诊断性冠状动脉造影的患者在结构化访谈的基础上进行独立评估，并被评定为A型、B型或X型（不确定）。传统的生理因素年龄、性别、胆固醇和吸烟被发现与动脉粥样硬化疾病相关。与仅轻度闭塞的患者相比，A型患者在中度至重度冠状动脉闭塞患者组中的比例增加。A型糖尿病患者的比例随着疾病严重程度的增加而增加，即使年龄、性别、血压、血清胆固醇水平和吸烟史都同时发生协变，这种增加也是显著的。这些发现表明，独立于传统的危险因素，A型行为模式可能通过影响动脉粥样硬化过程而导致临床CHD事件的风险。
SUMMARY Previous research has demonstrated an increased rate of clinical coronary heart disease (CHD) events among people who exhibit a "coronary prone" (Type A) behavior pattern. This study was undertaken to determine whether the association between behavior pattern Type A and CHD might be extended beyond clinical CHD events to include also the coronary atherosclerotic process. In addition to usual clinical evaluation, 156 consecutive patients referred for diagnostic coronary angiography were independently assessed on the basis of a structured interview and assigned a rating of Type A, Type B, or Type X (indeterminate). Traditional physiologic factors age, sex, cholesterol and cigarette smoking were found to correlate with atherosclerotic disease. Type A patients were found in increasing proportions among groups of patients with coronary occlusions of moderate to severe degree compared with patients with only mild occlusions. This increasing proportion of Type A patients with increasing disease severity remained significant, even when age, sex, blood pressure, serum cholesterol level and cigarette smoking history were all simultaneously covaried. These findings suggest that, independently of traditional risk factors, behavior pattern Type A may contribute to the risk of clinical CHD events via effects on the atherosclerotic process.