Stress bei Patienten: Stress als Prognosefaktor für Re-Infarkte bei koronarer Herzkrankheit

Zusammenfassung

Bisher wurde Stress als Prognosefaktor bei koronarer Herzkrankheit nur wenig beachtet. Wir möchten in diesem Artikel einen aktualisierten und umfassenden Überblick darüber geben, welche Rolle Stress bei der Prognose der koronaren Herzkrankheit spielen könnte. Stress wurde in unterschiedlichen Domänen gemessen. Die Synthese der Forschungsevidenz lässt vermuten, dass Stress das Risiko für wiederholte klinische Ereignisse bei Patienten mit koronarer Herzkrankheit um 55% (95%-Konfidenzintervall 32 – 83%) erhöhen kann. Die „European Guidelines on Cardiovascular Disease Prevention in Clinical Practice“, 2016 von der European Society of Cardiology veröffentlicht, weisen besonders auf die Rolle von Stress und psychosozialen Risikofaktoren hin. Insbesondere die „Cardiac Rehabilitation Section“ der European Association of Cardiovascular Prevention and Rehabilitation schlägt eine 2-stufige Evaluation eines potenziellen Risikos durch Stress für die klinisch-kardiologische Praxis vor.

Abstract

So far, stress has not been well-recognized as a risk and prognostic factor for coronary heart disease. In this article we would like to provide an updated and comprehensive overview on the role of stress in the prognosis of coronary heart disease. Stress was measured with different domains. Synthesis of research evidence suggested that stress could increase the risk of recurrent events by 55% (95% confidence interval 32 – 83%) in coronary heart disease patients. The 2016 European Guidelines on cardiovascular disease prevention in clinical practice by the European Society of Cardiology especially highlight the role of stress and psychosocial risk factors. In particular, the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation has also proposed a two-step evaluation of potential stress risk factors in clinical practice of cardiology.

Was ist wichtig?

• Bisher wurde der Einfluss von Stress bei der Prognose der koronaren Herzkrankheit wenig beachtet. Diese Metaanalyse zeigt, dass Stress das Risiko für wiederholte klinische Ereignisse bei Patienten mit koronarer Herzkrankheit um durchschnittlich 55% (95%-Konfidenzintervall 32 – 83%) erhöhen kann.

• In den Stressdomänen „allgemeiner Stress“ und „alltagsbezogener Stress“ liegt das Risiko tendenziell noch höher.

• Die European Society of Cardiology und die Cardiac Rehabilitation Section haben neue Leitlinien publiziert, in denen eine 2-stufige Beurteilung von Stress als möglichem Risikofaktor für die klinische Praxis in der Kardiologie vorgeschlagen wird.

Schlüsselwörter

Stress - koronare Herzkrankheit - wiederholte klinische Ereignisse

Key words

stress - coronary heart disease - recurrent events

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