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Objective: Studies have shown that chronic stress is closely linked to the occurrence and development of cardiovascular disease. To date, few studies have focused on perceived stress in coronary heart diseases (CHD) patients and the possible factors influencing the stress. This study aims to investigate the perceived stress of patients with CHD and determine the individual attributes closely associated with it., Design: A cross-sectional study., Participates: A total of 2215 patients with CHD were enrolled and perceived stress was assessed with the Chinese version Perceived Stress Scale (CPSS). Participants were divided into two groups due to CPSS score and binary logistic regression was applied to analyse the factors that affected perceived stress level., Results: The mean CPSS score of Chinese patients with CHD was 27.16±6.35 Compared with participants who received senior middle school education or below, those with a university degree had a higher probability of high perceived stress (OR 1.453, 95% CI 1.206 to 1.750); this difference was more evident in participants with a master or doctoral degree (OR 1.928, 95% CI 1.290 to 2.882). Also engaging in mental labour (OR 1.389, 95% CI 1.144 to 1.686), having children (OR 2.226, 95% CI 1.098 to 4.515) and having a habit of risky alcohol consumption (OR 1.492, 95% CI 1.146 to 1.944) were associated with perceived stress., Conclusion: Patients who had higher educational attainment, engaged in mental labour, had children, and had a habit of risky alcohol consumption were much easier to perceive the stress., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background. High stress is associated with coronary heart disease (CHD), but the impact of perceived stress on prognosis with stable CHD remains unclear. This study investigated the impact of high perceived stress (HPS) on cardiovascular events in stable CHD patients. Methods. From March 2015 and December 2020, 2215 stable CHD patients were recruited. The Chinese version of the Perceived Stress Scale-14 (CPSS) was used, with follow-up conducted every 6 months until the occurrence of a cardiovascular event or March 31, 2022. Cardiovascular-related events were used as outcomes, including myocardial infarction, unplanned revascularization, stroke, death, or rehospitalization from angina. Patients were divided into HPS (CPSS ≥ 31) and nonhigh perceived stress (NHPS) groups. The Kaplan-Meier survival curves were plotted, and the log-rank test compared the incidence of adverse events after adjusting for sociodemographic, lifestyle, and clinical information. Results. The recruited CHD population was 59.6 years old on average, 79.6% male, 27.2 points average CPSS, and median follow-up of 47 months. There were 523 HPS patients, with 98 (18.7%) cardiovascular events, and 1692 NHPS patients with 239 (14.1%) cardiovascular events. The log-rank analysis showed that risk of cardiovascular events with HPS was higher than NHPS (P = 0.012). After adjusting for demographic, lifestyle, and clinical information, the HPS group had significantly increased risk of events within 24 months (HR 1.369, 95% CI 1.037-1.807, P = 0.027), but less impact after 24 months. Conclusions. HPS predicts subsequent cardiovascular events in patients with stable CHD within 24 months. Therefore, more attention should be given to CHD patients with HPS, which may improve clinical prognosis. [ABSTRACT FROM AUTHOR]