Is impulsivity a risk factor of clinical events in acute coronary syndrome? A three-year follow-up study.

Objective: Several depressive symptoms increase the risk of adverse clinical events after acute coronary syndrome (ACS) but the potential effect of impulsivity has not been explored. The aim of the study was to investigate the effects of impulsivity on prognosis at 3-year follow-up in patients hospitalised for ACS.

Methods: Consecutively admitted ACS patients (n=277) completed the tenth version of the Barratt Impulsivity Scale (BIS 10) and the Hospital Anxiety and Depression Scale depression subscale (HAD-D) at baseline (1-4 days after their admission). The three subscales of the BIS 10 rating motor impulsivity (motor-BIS 10), attentional impulsivity (atten-BIS 10) and nonplanning impulsivity (nonplan-BIS 10) were taken into account. Patients were followed during 3 years for adverse clinical events divided into severe cardiac events (mortality or myocardial infarction (MI)), and clinical events (mortality, MI, recurrence of ACS, hospital readmission and onset or deterioration of heart failure (HF)).

Results: At follow-up, there were 135 clinical events including 40 severe cardiac events. Low motor impulsivity and high depression were associated with poor prognosis, but high levels of motor impulsivity were the only predictors of lower frequency of severe cardiac events after adjusting for demographic and clinical variables.

Limitations: The patients were recruited from only one hospital and lack of structured interview for assessment of depression.

Conclusions: Motor impulsivity predicted low incidence of severe cardiac events following ACS and the BIS can be used clinically.