International Journal of Behavioral Medicine

, Volume 26, Issue 6, pp 673–679 | Cite as

Alexithymia and Cardiac Outcome in Patients at First Acute Coronary Syndrome

  • Paolo Ossola
  • Maria Lidia GerraEmail author
  • Marco Beltrani
  • Carlo Marchesi
Brief Report



This cohort study was aimed to verify whether subjects at their first acute coronary syndrome (ACS) were more alexithymic than healthy controls (HC) and whether alexithymia can predispose patients with coronary artery disease to new major adverse cardiac events (MACE) during a 24-month follow-up period.


The sample included 100 HC with no history of depression or ACS and 304 never depressed patients with a first-ever ACS. A total of 266 patients completed the 2-year follow-up.


Patients and HC reported similar Toronto Alexithymia Scale (TAS-20) scores. During the follow-up, 69 (22.69%) patients developed incident depression and 57 (18.75%) developed a new MACE. In a proportional hazard model, developing a first-ever depressive episode, but not alexithymia (hazard ratio = 1.008, 95% confidence interval = 0.984–1.033; p = 0.500), was associated with almost 3 times the risk of a recurrent cardiac event.


Incident depression, but not TAS-20 scores, represented risk factor for MACE.


Coronary artery disease Alexithymia Incident depression Major cardiac adverse event 


Compliance with Ethical Standards

All procedures performed in this study, involving human participants, were in accordance with the ethical standards of the institutional research committee (Comitato Etico dell’Area Vasta Emilia Nord, segreteria di Parma, at the time of the study protocol approval, in 2009, Comitato Etico di Parma) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed written consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© International Society of Behavioral Medicine 2019

Authors and Affiliations

  1. 1.Department of Medicine and SurgeryUniversity of ParmaParmaItaly
  2. 2.Department of Mental HealthLocal Health Agency ParmaParmaItaly

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