RT Journal Article
SR Electronic
T1 Vital exhaustion in women with chest pain and no obstructive coronary artery disease: the iPOWER study
JF Evidence Based Mental Health
JO Evid Based Ment Health
FD BMJ Publishing Group Ltd, Royal College of Psychiatrists and British Psychological Society
SP 49
OP 55
DO 10.1136/ebmental-2020-300175
VO 24
IS 2
A1 Bechsgaard, Daria Frestad
A1 Gustafsson, Ida
A1 Michelsen, Marie Mide
A1 Mygind, Naja Dam
A1 Pena, Adam
A1 Suhrs, Hannah Elena
A1 Bove, Kira
A1 Hove, Jens Dahlgaard
A1 Prescott, Eva
YR 2021
UL http://mentalhealth.bmj.com//content/24/2/49.abstract
AB Background More than half of women with symptoms suggestive of myocardial ischaemia have no obstructive coronary artery disease (CAD), yet they face a higher risk of cardiovascular mortality and morbidity. Both vital exhaustion (VE) and depression have been linked to adverse cardiovascular prognosis in patients with CAD. We aimed to assess whether symptomatic women with no obstructive CAD are more vitally exhausted compared with asymptomatic women. Furthermore, we investigated the overlap between the constructs of VE and depression.Methods Prevalence and burden of VE was assessed in symptomatic women with no obstructive CAD (n=1.266) and asymptomatic women (n=2.390). Among symptomatic women, we also assessed chest pain characteristics and symptoms of Hospital Anxiety and Depression Questionnaire.Findings Median (IQR) VE score was 4 (1-9) and 2 (0–5) in symptomatic and asymptomatic women, respectively (age adjusted, p<0.001). The risk of severe VE was significantly higher in symptomatic women compared with asymptomatic women (OR 3.3, 95% CI 2.5 to 4.4), independent of age and risk factors, and was associated with symptom severity. VE and depression scores were correlated but principal component cluster analysis (PCCA) showed clear distinctiveness between the two constructs.Conclusions Women with chest pain and no obstructive CAD are more vitally exhausted compared with asymptomatic women. PCCA showed that VE is distinct from depression in symptomatic women.Clinical implications Mental health screening focusing on depressive symptomatology in women with chest pain presenting with symptoms of mental and physical exhaustion may overlook VE in these patients.Data are available on reasonable request. Data will be made available on reasonable request.