Psycho-affective profile of young adults with acute coronary syndrome

The increasing incidence of acute coronary syndromes (ACS) in young adults represents a growing public health concern. Recent studies suggest a potential influence of affective temperaments on cardiovascular diseases. The aim of this study was to characterize the psycho-affective traits of young patients with ACS and to assess the relationship between affective temperament and coronary artery disease. This was a cross-sectional, observational, descriptive, monocentric study conducted over 12 months (from 02/01/2023 to 01/01/2024) in the cardiology department of Habib Thameur Hospital. Presence of coronary artery disease was confirmed by coronary angiography. Temperament was measured with Temps M scale in Arabic version. Statistical analyses included group comparisons (CAD+ vs. CAD–) and receiver operating characteristic (ROC) curve analysis to evaluate the predictive value of temperament dimensions for CAD. A total of 120 young patients admitted for ACS were included. The median age was 42.5 years, with a male predominance (85%). Smoking (79%) was the most common cardiovascular risk factor, followed by dyslipidaemia (41.7%) and a family history of coronary artery disease (28.3%). The analysis of TEMPS-M affective temperament scores revealed a heterogeneous distribution of affective profiles in our cohort. A predominant depressive temperament was observed in 10% of patients, cyclothymic in 20%, hyperthymic in 24.2%, irritable in 29.1%, and anxious in 16.7%. Analysis of affective temperament profiles revealed that cyclothymic and irritable temperaments were significantly more prevalent in the CAD+ group, while hyperthymic and anxious temperaments were more common in the CAD– group. No significant difference was found for depressive temperament. ROC curve analysis indicated that cyclothymic (cut-off >15; sensitivity 65%, specificity 65%) and irritable (cut-off >17; sensitivity 70%, specificity 65%) temperaments were good predictors of CAD. In contrast, hyperthymic and anxious temperaments were associated with a lower likelihood of CAD. ACS in young patients presents specific clinical and pathophysiological features. Assessing affective temperament may serve as a complementary tool for coronary artery disease screening. • This study led to an update in the management modalities of acute coronary syndrome (ACS). • It is the first study in Tunisia to investigate the link between affective temperament and ACS in young individuals. • The TEMPS-M 35 affective temperament scale was used to assess temperament traits. • The TEMPS-M 35 is brief, easy to administer, and well-suited for clinical use. • Given that affective temperament is a stable lifelong trait, the scale can be integrated into routine clinical practice with ease.