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Abstract 11260: Psychosocial Factors Amongst Women with MINOCA


 Introduction:
 Women are particularly vulnerable to high stress and depression after myocardial infarction (MI), and both are associated with increased post-MI mortality. MI with non-obstructive coronary arteries (MINOCA) disproportionately affects women. Little is known about the degree to which stress and depression levels around the time of MI relate to the type of MI in women. We aimed to determine whether psychosocial factors differ between women with MINOCA and those with MI and obstructive CAD (MI-CAD).
 
 
 Methods:
 Women with MI enrolled in a multicenter study completed baseline measures of perceived stress (Perceived Stress Scale [PSS-4]), depressive symptoms (Patient Health Questionnaire [PHQ-2]), major life stressors (life events checklist [LEC]) and psychological resilience (Brief Resilience Scale [BRS]) at the time of hospitalization for acute MI. PSS-4 and PHQ-2 were repeated at 2-months post-MI. Psychosocial measures were compared between patients with MINOCA and those with MI-CAD at baseline and 2-month follow-up using t-test and chi-square.
 
 
 Results:
 This study compared 172 MINOCA patients and 314 MI-CAD patients. Women with MINOCA were younger (59.4±12.5 vs 64.2±12.9 years, p<0.001) and less likely to be non-Hispanic white (52.3% vs 64.3%, p=0.004). Women with MINOCA were less likely to have high stress (PSS-4 ≥6) at the time of MI (51.0% vs 63.0% vs, p=0.021) and at 2-months post-MI (32.5% vs 46.3%, p=0.019) compared to women with MI-CAD. There was no difference in the proportion with depressive symptoms (PHQ-2 ≥2) at the time of MI (36.2% MINOCA vs 42.7% MI-CAD, p=0.23) or at 2-months post-MI (39.0% vs 39.5%, P>0.99). MINOCA patients reported fewer major life stressors than MI-CAD patients (LEC 2.67±1.93 vs 3.13±1.80, p=0.015). The frequency of low psychological resilience (BRS<18) (24.3% vs 21.6%, p=0.60) did not differ between MINOCA and MI-CAD patients.
 
 
 Conclusions:
 Stress and depression are common among women at the time of, and 2-months post-MI. MINOCA patients reported lower stress levels at the time of and following MI compared to MI-CAD patients and fewer traumatic life events, but depressive symptoms and resilience did not differ by MI type.
