Emotional Stress as A-Major Risk Factor for Type 1 Myocardial Infarction

Background: Acute mental stress has been known as an important precipitating factor of acute coronary syndrome (ACS) especially myocardial infarction events, through platelet activation resulting in hypercoagulability status. Type 1 myocardial infarction is due to coronary atherosclerotic plaque rupture. A previous autopsy study showed that not all ruptured atherosclerotic plaques result in thrombus formation. Data collected from previous study identified five differentially expressed platelet genes: (FKBP5, S100P, SAMSN1, CLEC4E and S100A12) at the time of acute myocardial infarction and the gene that showed the highest evidence of differential expression was FKBP5. Previous studies show that extreme emotions were associated with FKBP5 gene expression.
Objective: To evaluate emotional stress as a risk factor for type 1 myocardial infarction.
Patients and Methods: This prospective study was performed on 90 cases divided into two main groups: healthy participant group (30) and ACS group (60) that was further subdivided into ST-elevation MI (STEMI) group (30) and unstable angina (UA) group (30) who underwent percutaneous coronary intervention and polymerase chain reaction.
Results: Our results demonstrated that there was statistically significant increase in the percentage of patients with emotional stress in STEMI group than control group and UA groups with p-value <<0.001. FKBP5 gene expression was statistically significant higher in STEMI group followed by UA group and lastly the lower value was found in control group with p-value <0.001. FKBP5 gene expression level was significantly higher in cases with emotional stress in STEMI group with p-value = 0.007.
Conclusion: Emotional stress is a major risk factor for type 1 MI. Emotional stress can cause activation of FKBP5 platelet gene that in turn can cause platelet activation resulting in thrombus formation.