Table 2.

Sex differences in perceived stress scale (PSS)-14 score over time after acute myocardial infarction.

Explanatory variable	Model 1 (without adjustment for patient characteristics)		Model 2 (with adjustment for baseline sociodemographic and health characteristics)		Model 3 (with further adjustment for AMI severity)		Model 4 (with further adjustment for angina health and psychosocial risk factors)

	Coefficient	P value	Coefficient	P value	Coefficient	P value	Coefficient	P value
Female (vs. male)	3.63	<.001	2.76	<.001	2.72	<.001	1.74	<.001
Time
1 month (vs. baseline)	−3.99	<.001^a	−3.96	<.001^a	−3.96	<.001^a	−2.00	<.001^a
12 months (vs. baseline)	−4.72^b	<.001^a	−4.64^c	<.001^a	−4.64^d	<.001^a	−2.36^e	<.001^a
Country
Spain (vs. U.S.)	−0.97	0.29^a	−0.77	0.73^a	−1.06	0.25^a	−0.44	>.99^a
Australia (vs. U.S.)	−1.77	0.77^a	−0.43	>.99^a	−0.52	>.99^a	0.53	>.99^a
Interaction terms
Spain x 1 month	3.01	<.001	3.01	<.001	3.01	<.001	2.79	<.001
Spain x 12 months	4.44	<.001	4.42	<.001	4.42	<.001	3.07	<.001
Australia x 1 month	0.78	0.50	0.66	0.56	0.67	0.55	−0.21	0.84
Australia x 12 months	0.88	0.51	0.64	0.63	0.65	0.63	−0.82	0.50

Coefficient estimates and p values were based on results from multivariable linear mixed effects models to account for correlation in repeated measures within the same individual over time. AMI = acute myocardial infarction.

Model 1 adjusted for patient sex, time, and country.

Model 2 further adjusted for patient’s baseline age, race, education, marital status, number of children living in household, financial status, employment status, and number of comorbid conditions at baseline, in addition to all variables in Model 1.

Model 3 further adjusted for AMI characteristics at initial admission, including ST-segment-elevation myocardial infarction (STEMI) versus non-STEMI, cardiogenic shock upon hospital admission, ejection fraction <40%, Global Registry of Acute Coronary Events (GRACE) risk score >99, hemodynamic instability on arrival, presentation to the hospital >6 hours after symptom onset, and length of stay during the initial hospitalization, in addition to all variables in Model 2.

Model 4 further adjusted for time-varying measures of Seattle Angina Questionnaire (SAQ) angina frequency and angina-related physical limitation scores, the INTERHEART stressful life events scale, low social support determined by the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Social Support Inventory (ESSI), and depression based on the Patient Health Questionnaire (PHQ-9), in addition to all variables in Model 3.

P value adjusted with step-down Bonferroni.

Implied a difference of −0.74 between 1-month and 12-month follow-up (p<.001).

Implied a difference of −0.68 between 1-month and 12-month follow-up (p<.001).

Implied a difference of −0.37 between 1-month and 12-month follow-up (p=0.26).