PSYCHOLOGICAL PREDICTORS AND LONG-TERM CONSEQUENCES OF DELAYED HOSPITALIZATION IN MYOCARDIAL INFARCTION

Abstract

Aim. To reveal the personal-behavioral predictors of later than 6 hours after onset MI hospitalization and to compare these with parameters and predictors of mortality during 5 year follow-up.Material and methods. In 203 men (mean age 58,34±10,44 y.), had being treated for MI, the timing of hospitalization compared depending on psychological testing parameters at the moment of somatic stabilization achievement, as the lethal cases, during 5-year period. Results. On time hospitalization (OH) — in 6 hours from the onset of heart attack — took place in 28,08% of patients, and delayed (DH) — later than 6 hours — in 71,92% (p=0,001). During 5 years of follow-up 28,57% of patients died, of those in OH group 15,79% and in DH group — 33,56% (p=0,037). Psychological predictors of DH cases as long-term mortality were the prevalence of behavioral type A, aggressiveness increase as alexithymia with a decrease of subjective control in misfalls and harmony of disease relationship.Conclusion. The problem of on time MI treatment is still non-solvable without psychology of coronary patient, their personality-behavioral properties, which might become a psychological supplement for OH and be against this. Psychotherapeutical reliance on the former and correction of the latter should be used in psychoprophylaxy of DH in high risk ACS patients.

Keywords

• myocardial infarction
• delayed and on time hospitalization
• hostility
• behavioral type a
• alexithymia
• the level of subjective control