ABSTRACT
The objective of this study is to examine the role of a particular stress-enhancing psychosocial risk factor, termed overcommitment, in predicting restenosis after successful percutaneous transluminal coronary angioplasty (PTCA). Overcommitment defines a personal pattern of coping with demands characterized by excessive striving in combination with a strong desire of being approved and esteemed. One hundred six consecutive male patients with coronary artery disease who underwent PTCA were followed over a mean of 12 months. The restenosis rate as defined by quantitative angiography was 34%. Multivariate analysis revealed independent effects of high density lipoprotein cholesterol (odds ratio [OR] 3.19), age (OR 3.43), and overcommitment (OR 2.86) on risk of restenosis. In conclusion, a stress-enhancing psychosocial person characteristic termed overcommitment acts as an independent predictor of coronary restenosis after PTCA. As overcommitment is subject to cognitive-behavioral intervention, results have implications for a more comprehensive approach to secondary prevention in cardiac patients.
ABSTRACT
Anaphylactic tests in guinea pigs and double-diffusion tests with rabbit serum produced no evidence of antigen-like properties of polyvinylpyridine-N-oxide (PVNO). It is very unlikely therefore that the occasional clinical observations of collapse-like states, occurring when PVNO injection is resumed after a treatment-free interval are of allergic nature. These are most probably due to erythrocyte aggregation following excessively rapid injection of PVNO, producing collapse in the terminal pulmonary vasculature by a reflex action. This reaction can be avoided by slow intravenous injection or infusion.
