Academic Commons

Articles

The ‘Perfect Storm’ and Acute Coronary Syndrome Onset: Do Psychosocial Factors Play a Role?

Burg, Matthew M.; Edmondson, Donald E.; Shimbo, Daichi; Shaffer, Jonathan; Kronish, Ian M.; Whang, William; Alcantara, Carmela; Schwartz, Joseph E.; Muntner, Paul; Davidson, Karina W.

The revolution in cardiac care over the past two decades, characterized by emergent revascularization, drug eluting stents, anti-platelet medications, and advanced imaging has had little impact on overall ACS recurrence, or ACS prevention. The “Perfect Storm” refers to a confluence of events and processes, including atherosclerotic plaque, coronary flow dynamics, hemostatic and fibrinolytic function, metabolic and inflammatory conditions, neurohormonal dysregulation, and environmental events that give rise to, and result in an ACS event. In this article we illustrate the limits of the traditional main effect research model, giving a brief description of the current state of knowledge regarding the development of atherosclerotic plaque and the rupturing of these plaques that defines an ACS event. We then apply the Perfect Storm conceptualization to describe a program of research concerning a psychosocial vulnerability factor that contributes to increased risk of recurrent ACS and early mortality, and that has defied our efforts to identify underlying pathophysiology and successfully mount efforts to fully mitigate this risk.

Files

  • thumnail for Burg_Prog_Cardiovasc_Dis_2013_PMC_Version.pdf Burg_Prog_Cardiovasc_Dis_2013_PMC_Version.pdf application/pdf 583 KB Download File

Also Published In

Title
Progress in Cardiovascular Diseases
DOI
https://doi.org/10.1016/j.pcad.2013.03.003

More About This Work

Academic Units
Center for Behavioral Cardiovascular Health
Social Work
Published Here
March 30, 2016
Academic Commons provides global access to research and scholarship produced at Columbia University, Barnard College, Teachers College, Union Theological Seminary and Jewish Theological Seminary. Academic Commons is managed by the Columbia University Libraries.