CONTEXT: There is evidence that job strain increases the risk of a first @entity301 ( @entity301 ) event. However, little is known about its association with the risk of recurrent @entity301 events after a first @entity583 ( @entity583 ). OBJECTIVE: To determine whether job strain increases the risk of recurrent @entity301 events. DESIGN, SETTING, AND @entity1 : Prospective cohort study of 972 @entity1 and @entity1 aged 35 to 59 years who returned to work after a first @entity583 and were then followed up between February 10, 1996, and June 22, 2005. @entity1 were interviewed at baseline (on average, 6 weeks after their return to work), then after 2 and 6 years subsequently. Job strain, a combination of high psychological demands and low decision latitude, was evaluated in 4 quadrants: high strain (high demands and low latitude), active (high demands and high latitude), passive (low demands and low latitude), and low strain. A chronic job strain variable was constructed based on the first 2 interviews, and @entity1 were divided into those exposed to high strain at both interviews and those unexposed to high strain at 1 or both interviews. The survival analyses were presented separately for 2 periods: before 2.2 years and at 2.2 years and beyond. MAIN OUTCOME MEASURE: The outcome was a composite of fatal @entity301 , nonfatal @entity583 , and @entity1459 . RESULTS: The outcome was documented in 206 @entity1 . In the unadjusted analysis, chronic job strain was associated with recurrent @entity301 in the second period after 2.2 years of follow-up (hazard ratio [HR], 2.20; 95% CI, 1.32-3.66; respective event rates for @entity1 exposed and unexposed to chronic job strain, 6.18 and 2.81 per 100 @entity1 -years). @entity102 remained an independent predictor of recurrent @entity301 in a multivariate model adjusted for 26 potentially confounding factors (HR, 2.00; 95% CI, 1.08-3.72). CONCLUSION: @entity102 after a first @entity583 was associated with an increased risk of recurrent @entity301 .

Job strain and risk of acute recurrent XXXX events.

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients', 'PATIENTS', 'person', 'men'] @entity301 :: ('MESH:D003327', 'Disease') :: ['CHD', 'coronary heart disease'] @entity102 :: ('MESH:D002908', 'Disease') :: ['Chronic job strain'] @entity1459 :: ('MESH:D000789', 'Disease') :: ['unstable angina'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction', 'MI']
@entity301 :: (MESH:D003327,Disease) :: ['coronary heart disease']
