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Acute Coronary Syndrome: Emotion and Triggers (ACCENT) Study

The ACCENT study was designed to investigate psychophysiological processes involved in the emotional triggering of acute coronary syndromes (ACS). It involved detailed interviewing of 295 ACS patients within two days of admission to one of four London hospitals, with follow-up assessments after 4, 12 and 36 months. Primary data collection was completed in 2005, but the results continue to be analyzed. Among the issues that have been investigated are:

· The role of anger, depression and physical exertion in triggering acute coronary syndromes

· The biological pathways underlying emotional triggering of ACS

· The long-term sequelae of emotional triggering of ACS

· Psychosocial factors contributing to delays in seeking help after onset of acute cardiac symptoms

· Post-traumatic stress symptoms in patients following ACS

· Type D personality

· Social networks, stress and support in relation to adherence to medical and lifestyle advice in cardiac patients.

Key references:

Bhattacharyya, M.R., Perkins-Porras, L., Wikman, A., and Steptoe, A. (2010). The long-term effects of acute triggers of acute coronary syndromes on adaptation and quality of life. International Journal of Cardiology, 138, 246-252.

Molloy, G.J., Perkins-Porras, L., Strike, P.C., and Steptoe, A. (2008). Social networks and partner stress as predictors of adherence to medication, rehabilitation attendance and quality of life following acute coronary syndrome. Health Psychology, 27, 52-58.

Molloy,G.J., Perkins-Porras, L., Strike, P.C., Steptoe, A. (2008). Type-D personality and cortisol in survivors of acute coronary syndrome. Psychosomatic Medicine 70, 863-868.

Perkins-Porras, L., Whitehead, D.L., Strike, P.C., and Steptoe, A. (2008). Causal beliefs, cardiac denial and pre-hospital delays following the onset of acute coronary syndromes. Journal of Behavioral Medicine, 31, 498-505.

Steptoe, A., and Brydon, L. (2009). Emotional triggering of cardiac events. Neuroscience and Biobehavioral Reviews, 33, 63-70.

Strike, P.C., Magid, K., Whitehead, D.L., Brydon, L., Bhattacharyya, M., and Steptoe, A. (2006). Psychophysiological processes underlying emotional triggering of acute coronary syndromes. Proceedings of the National Academy of Science, USA, 103, 4322-4327.

Strike, P.C., Perkins-Porras, L., Whitehead, D.L., McEwan, J., and Steptoe, A. (2006). Triggering of acute coronary syndromes by physical exertion and anger: clinical and sociodemographic characteristics. Heart, 92, 1035-1040

Wikman, A., Bhattacharyya, M.R., Perkins-Porras, L., and Steptoe, A. (2008). Persistence of posttraumatic stress symptoms 12 and 36 months after acute coronary syndrome. Psychosomatic Medicine. 70, 764-772.

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