Coronary-Prone Behavior: One Pattern or Several

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Abstract
A cohort of 2750 healthy men who responded to a 61-item questionnaire was studied prospectively for 4 yr, by which time 67 sustained acute myocardial infarctions (AMI), 30 were discovered by ECG who had myocardial infarctions which had gone clinically unrecognized (silent) SMI, and 23 developed classical angina pectoris without ECG changes indicative of infarction. Item analysis of the questionnaire using multi-group optimal scaling and discriminant function revealed the patterns of responses to be characteristically different among the 3 clinical presentations of coronary heart disease [CHD] and those men who remained healthy. The psychological properties of the 3 significant dimensions of discrimination were discussed. A 2nd study, involving healthy men from the same population, supported the inference that the dimensions isolated were statistically and psychologically genuine. Different facets of the CHD-prone Type A behavior pattern may be specifically associated with different clinical manifestations of CHD. Refinement of these dimensions may lead to more specific prediction of CHD risk in the future.

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