PSYCHOBEHAVIORAL FACTOR, ALEXITHYMIA, IS RELATED TO CORONARY SPASM

The aim of this study was to assess whether the psychobehavioral patte rn alexithymia is related to coronary artery spasm. Alexithymia, defic ient psychological awareness, was examined using the Minnesota Multiph asic Personality Inventory Alexithymia Scale in 100 patients with angi na pectoris in whom coronary spasm, defined as greater than or equal t o 99% coronary narrowing, was documented upon ergonovine provocation, and in 109 patients with chest pain syndrome who were shown to have al most normal coronaries without inducible coronary spasm on coronary an giogram (control group). Alexithymia was approximately twice as preval ent in the coronary spasm group (31%) as in the control group (14%) (p < 0.01). Among various conventional risk factors including hyperlipid emia, obesity, diabetes mellitus, hypertension, hyperuricemia, or fami ly history of ischemic heart disease, only male sex and smoking were m ore prevalent in the coronary spasm group than in the control group (p < 0.001). The odds ratios of coronary spasm adjusted for all the othe r risk parameters including sex and age were 4.14 [95% confidence inte rval (CI) 1.81-9.47] for alexithymia and 2.38 (95% CI 1.18-4.82) for s moking. A psychobehavioral pattern, alexithymia, relates to coronary s pasm. This relationship is independent of the conventional coronary ri sk factors.