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Cognitive Adaptation as a Predictor of New Coronary Events After Percutaneous Transluminal Coronary Angioplasty

Helgeson, Vicki S. PhD; Fritz, Heidi L. PhD

Original Articles

Objective We tested whether the psychological components of cognitive adaptation theory would predict new coronary events after a first percutaneous transluminal coronary angioplasty (PTCA).

Methods A consecutive sample of patients treated successfully with PTCA were enrolled in the study. Of 343 patients approached, 303 (88%) agreed to participate and were interviewed shortly before hospital discharge. We measured the components of cognitive adaptation theory (optimism, self-esteem, and mastery) during the interview. Five patients were excluded from the analysis because of early, in-hospital reocclusion. New cardiac events (coronary artery bypass grafting, PTCA, myocardial infarction, or disease progression) were examined within 6 months of the first PTCA. We obtained 6-month follow-up data on 98% of patients.

Results The cognitive adaptation index predicted new cardiac events, even when demographic variables and medical variables thought to predict restenosis were statistically controlled (p = .02).

Conclusions These results suggest that persons who respond to their illness by perceiving control over their futures, by having positive expectations about their futures, and by holding a positive view of themselves seem to be at less risk for a new cardiac event after a first PTCA.

From Carnegie Mellon University (V.S.H.) and University of Pittsburgh (H.L.F.), Pittsburgh, PA.

Address reprint requests to: Vicki S. Helgeson, PhD, Psychology Department, Carnegie Mellon University, Pittsburgh, PA 15213. Email:

Received for publication October 12, 1998; revision received February 11, 1999.

Copyright © 1999 by American Psychosomatic Society
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