Cognitive adaptation as a predictor of new coronary events after percutaneous transluminal coronary angioplasty

Objective: We tested whether the psychological components of cognitive adap tation 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 s hortly before hospital discharge. We measured the components of cognitive a daptation theory (optimism, self-esteem, and mastery) during the interview. Five patients were excluded from the analysis because of early, in-hospita l reocclusion. New cardiac events (coronary artery bypass grafting, PTCA, m yocardial infarction, or disease progression) were examined within 6 months of the first PTCA, We obtained B-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 resteno sis were statistically controlled (p = .02). Conclusions: These results sug gest that persons who respond to their illness by perceiving control over t heir futures, by having positive expectations about their futures, and by h olding a positive view of themselves seem to be at less risk for a new card iac event after a first PTCA.