Kenneth E. Freedland, Ph D; Yasuyuki Nakamura, MD; Robert M. Carney, Ph D; Robert B. Case, MD; Nan B. Case, Ph D; Chuichi Kawai, MD; Ronald J. Krone, MD; Nobumasa Kato, MD; Masahiko Kinoshita, MD

Abstract
To determine whether specific psychological characteristics are associated with angina pectoris in clinically stable patients 1 to 6 months after recovery from an acute coronary event, a battery of tests was administered to 92 Japanese and 646 North American participants (22% females) in the Multicenter Study of Myocardial Ischemia. Of these 738 patients, 541 had originally suffered acute myocardial infarction, 188 had unstable angina, and 9 were admitted for other acute ischemic events. At the time of enrollment, an average of 2.7 months after the index event, 205 patients reported having had anginal symptoms during the preceeding month. Compared to those who did not report angina, these patients scored higher on a modified Autonomic Perception Questionnaire (p=0.04) and lower on the Internal Health Locus of Control Scale (p=0.004). These differences were generalized across the Japanese and North American cohorts. These results indicate that in these patients, angina pectoris was associated with an increased awareness of a wide range of physical symptoms and a decreased sense of personal control over one's own health and prognosis.
(Jpn Circ J 1997; 61: 299-307)

Key Words: Angina pectoris/px; Coronary disease/px; Cross-cultural comparison; Myocardial infarction/px

Mailing address: Kenneth E. Freedland, Ph D, Department of Psychiatry, Washington University School of Medicine, P.O. Box 14109, St Louis, Missouri 63178 USA