Socioeconomic deprivation and prognostic outcomes in acute coronary syndrome: A meta-analysis using multidimensional socioeconomic status indices

Anand, Vickram Vijay; Zhe, Ethan Lee Cheng; Chin, Yip Han; Goh, Rachel; Lin, Chaoxing; Kueh, Martin Tze Wah; Chong, Bryan; Kong, Gwyneth; Tay, Phoebe Wen Lin; Dalakoti, Mayank; Muthiah, Mark; Dimitriadis, Georgios K.; Wang, Jiong‐Wei; Mehta, Anurag; Foo, Roger; Tse, Gary; Figtree, Gemma A.; Loh, Poay Huan; Chan, Mark Y; Mamas, Mamas A.; Chew, Nicholas

doi:10.1016/j.ijcard.2023.04.042

Cited by 12 publications

(4 citation statements)

References 70 publications

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“…Systematic reviews and meta-analyses of prospective studies have revealed associations between psychosocial stress and an increased risk of incident ASCVD (►Table 2), 28,[56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74] as well as poor prognosis in established ASCVD (►Table 3) 69, [75][76][77][78][79][80][81][82] ; both scenarios being complicated by atherothrombotic events. This literature is primarily concerned with psychosocial risk factors of coronary heart disease (CHD), followed by cerebrovascular disease and peripheral artery disease (PAD).…”

Section: Stress As a Risk Factor For Thrombotic Disease Evidence From...mentioning

confidence: 99%

“…The heightened risk of ASCVD with stress appears to be largely independent of demographic and other established risk factors and of a similar magnitude. 91 Covariate adjustment has been shown to attenuate the prospective association between stress and ASCVD/VTE in some studies, 58,75,78,79,82,87,89 yet not universally, as adjusted studies sometimes reveal stronger associations than unadjusted ones. 64,65,72 Psychotropic drugs may alter thrombotic disease risk in patients with psychological distress.…”

Section: Stress As a Risk Factor For Thrombotic Disease Evidence From...mentioning

confidence: 99%

“…130 Moreover, there is evidence to suggest causal effects of platelet reactivity, 124 elevated levels of VWF, 131 fibrinogen, 128 prothrombin, 128 FVIII activity, 126 FXI, 128 and PAI-1 131 on increased incident VTE risk. Low socioeconomic status 75 Low socioeconomic status 76 Work stress 77 Low functional social support 78 Low structural social support 78 Anger proneness/hostility 69…”

Section: Evidence From Mendelian Randomization Studiesmentioning

confidence: 99%

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Stress-Induced Hypercoagulability: Insights from Epidemiological and Mechanistic Studies, and Clinical Integration

von Känel

2024

Semin Thromb Hemost

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By integrating findings from comprehensive reviews, meta-analyses, and cutting-edge genetic studies, this article illuminates the significance of stress-induced hypercoagulability in clinical medicine. In particular, the findings from numerous prospective cohort studies indicate that stress and hemostatic factors of a hypercoagulable state are associated with increased incident risk and poor prognosis for atherosclerotic cardiovascular disease and venous thromboembolism. Mendelian randomization studies suggest that these associations are partially causal. The review synthesizes extensive research on the link between acute and chronic stress and hypercoagulability, outlining a potential pathway from stress to thrombosis risk. Consistent with the allostatic load concept, acute stress-induced hypercoagulability, initially adaptive, can turn maladaptive under chronic stress or excessive acute stress, leading to arterial or venous thrombotic events. Individuals with predisposing factors, including atherosclerosis, thrombophilia, or immobilization, may exhibit an increased risk of thrombotic disease during stress. Contextual sociodemographic characteristics, the stress experience, and coping resources additionally modulate the extent of stress-induced hypercoagulability. Research into the neuroendocrine, cellular, and molecular bases reveals how stress influences platelet activation coagulation and fibrinolysis. The activation of the sympathetic nervous system and the hypothalamic–pituitary–adrenal axis, along with vagal withdrawal, and the effects of catecholamines, cortisol, and vasopressin, are the central mechanisms involved. Hemoconcentration, inflammation, endothelial dysfunction, and thrombopoiesis additionally contribute to stress-induced hypercoagulability. Further research is needed to prove a causal link between chronic stress and hypercoagulability. This includes exploring its implications for the prevention and management of thrombotic diseases in stressed individuals, with a focus on developing effective psychosocial and pharmacological interventions.

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Section: Stress As a Risk Factor For Thrombotic Disease Evidence From...mentioning

confidence: 99%

Section: Stress As a Risk Factor For Thrombotic Disease Evidence From...mentioning

confidence: 99%

Section: Evidence From Mendelian Randomization Studiesmentioning

confidence: 99%

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Stress-Induced Hypercoagulability: Insights from Epidemiological and Mechanistic Studies, and Clinical Integration

von Känel

2024

Semin Thromb Hemost

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“…Prior research has yielded a collection of review articles addressing varied aspects of ACS management inequalities, 20 socioeconomic inequities linked to ACS, 31 , 32 racial and ethnic disparities therein, 27 , 33 and the influence of nonstandard modifiable risk factors on ACS mortality. 34 In the context of young female patients, previous reviews have provided exploration of topics ranging from risk factors linked to ACS, 24 to psychosocial aspects of recovery following acute myocardial infarction, 35 alongside discussion on the epidemiology, diagnosis, and treatment of acute myocardial infarction.…”

mentioning

confidence: 99%

Gender-Related Factors Associated With Outcomes of Acute Coronary Syndrome in Young Female Patients

Angarita-Fonseca,

Peebles,

Pilote

2024

CJC Open

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Sex differences in survival following acute coronary syndrome with and without standard modifiable risk factors

Anand,

Koh,

Teo

et al. 2024

Clin Res Cardiol

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Socioeconomic deprivation and prognostic outcomes in acute coronary syndrome: A meta-analysis using multidimensional socioeconomic status indices

Cited by 12 publications

References 70 publications

Stress-Induced Hypercoagulability: Insights from Epidemiological and Mechanistic Studies, and Clinical Integration

Stress-Induced Hypercoagulability: Insights from Epidemiological and Mechanistic Studies, and Clinical Integration

Gender-Related Factors Associated With Outcomes of Acute Coronary Syndrome in Young Female Patients

Sex differences in survival following acute coronary syndrome with and without standard modifiable risk factors

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