Hostility predicts mortality but not recurrent acute coronary syndrome
Authors: Kathleen Dracup
Tracey K Vitori
Debra K Moser
Martha J Biddle
Susan K Frazier
Michele M Pelter
Gia Mudd-Martin
Journal: European Journal of Cardiovascular Nursing (2020)
Discipline: CLINICAL MEDICINE
Keywords: Hostility; acute coronary syndrome; cardiovascular disease.
Affiliations: University of Tennessee College of Nursing, USA, University of Kentucky College of Nursing, USA, University of California, San Francisco, USA

Abstract:  Background: Hostility is associated with greater risk for cardiac disease, cardiac events and dysrhythmias. Investigators have reported equivocal findings regarding the association of hostility with acute coronary syndrome (ACS) recurrence and mortality. Given mixed results on the relationship between hostility and cardiovascular outcomes, further research is critical. Aims: The aim of our study was to determine whether hostility was a predictor of ACS recurrence and mortality. Methods: We performed a secondary analysis of data (N = 2321) from a large randomized clinical trial of an intervention designed to reduce pre-hospital delay among patients who were experiencing ACS. Hostility was measured at baseline with the Multiple Adjective Affect Checklist (MAACL) and patients were followed for 24 months for evaluation of ACS recurrence and all-cause mortality. We used Cox proportional hazards modeling to determine whether hostility was predictive of time to ACS recurrence or all-cause mortality. Results: The majority of patients were married (73%), Caucasian (97%), men (68%), and had a mean age of 67 ± 11 years. Fifty-seven percent of participants scored as hostile based on the established MAACL cut point (mean score = 7.56 ± 3.8). Hostility was an independent predictor of all-cause mortality (p = &lt; 0.039), but was not a predictor of ACS recurrence (p = 0.792). Conclusion: Hostility is common in patients with ACS and its relationship to clinical outcomes is important to the design of future interventions to improve long-term ACS mortality. 

Retracted: No

PubPeer comments:
 After a closer look at this paper, I have a few questions: Why does the corresponding author use a complete anonyomous email account? In the Materials and Methods section you describe the in vivo experiments. You say you used a total of 20 mice, but 6 (subcutanous injection) + 20 (lung metastasis) = 26. I am questioning the statistical significance when you are only using 6 mice. It is also difficult to understand how the presented tumor growth correspond with the tumor size presented in the images. According to the tumor size shown in the image, there is more variation in size and the tumors are generally smaller. In the Materials and Methods you also describe that you have been using and antibody from Abcam (ab91065) in Western immunoblotting. This antibody from Abcam is detecting HS3ST1, but according to the presented Western blot you are detecting HS3ST3B1. They do not share the same aa sequence. In the same paragraph you also describe the Western immunoblotting procedure. You used an anti-rabbit IgG secondary antibody and then used a Chemidoc imaging system to  develop and calculate the gray value . Didn t you use a substrate? The presented micrographs in Figure 2, 4 and 5 look strange. They are blurred and the patterns are in many cases unusual. ![file] ![file] ,