0085 Psychosocial working environment for patients with ischaemic heart disease and association to adverse cardiac events
研究调查了528名经皮冠状动脉介入治疗后重返工作的缺血性心脏病患者，发现心理社会工作环境与不良心脏事件风险无显著关联，但报告最差工作环境的患者风险反而较低，可能因脆弱者未返岗。
<h3>Objectives</h3> During the last decades a possible association between the psychosocial working environment and increased risk of Ischaemic heart disease (IHD) has been debated. A systematic review from 2009 found moderate evidence that high psychological demands, lack of social support and iso-strain was associated with IHD. Whether the psychosocial working environment plays a role for patients with existing cardiovascular disease on the risk of new cardiac events and readmissions is unknown <h3>Method</h3> A cohort of patients under 65 years and treated with Percutaneous Coronary Intervention was established in 2006. Three months after the procedure the patients answered a questionnaire about their psychosocial working environment. A total of 528 patients had returned to work 12 weeks after the procedure, while 97 were still sick-listed. Patients were followed in registers for 3+ years to determine cardiac readmissions and events. We examined the association between psychosocial working environment and adverse events among those who had returned to work at 3 months by Cox Regression analysis. <h3>Results</h3> We were not able to detect any significant associations between psychosocial working environment in terms of quantitative and cognitive demands, workload, involvement, influence, tolerance, social support, the combinations of effort-reward and demand-control and the risk of adverse events. <h3>Conclusions</h3> Reporting of problems in the psychosocial working environment are not associated with risk of adverse cardiac events. However, tendencies of a lower risk of cardiac event were present for employees reporting the worst psychosocial environment. This unexpected finding may be explained by vulnerable persons not returning to work.