Relationship between kinesiophobia levels,HH-SESM scores,and major adverse cardiovascular events in patients with stable coronary artery disease

Tian Xiaomiao; Ding Xueru; Wang Baozhu; Liang Min; Gao Minyan; Zhang Wuqiong; Wu Jing; Yao Na

doi:10.11986/j.issn.1673-873X.2025.08.02

Abstract：Objective To investigate the relationship between kinesiophobia levels,Heart Health Self-Efficacy and Self-Man-agement Scale(HH-SESM)scores,and major adverse cardiovascular events(MACE)in patients with stable coronary arter-y disease(SCAD),providing references for reducing MACE risk.Methods A total of 437 SCAD patients admitted to the First Affiliated Hospital of Xinjiang Medical University from October 2021 to October 2022 were followed for 24 months via telephone and outpatient return visit to record MACE.Patients were assigned to MACE(n=78)and non-MACE(n=359)groups based on the presence or absence of MACE.General data,Tampa Scale for Kinesiophobia Swedish Version for the Heart(TSK-SV Heart)scores,and HH-SESM scores were compared.Pearson correlation was used to analyze TSK-SV Heart and HH-SESM score relationships.ROC curves were employed to evaluate their predictive value for MACE risk,and multivariate logistic regression was adopted to identify MACE influencing factors.Results No significant differences were noted in gender or age between groups(P＞0.05).The MACE group had significantly higher proportions of hypertension,diabetes,dyslipidemia,and smoking history(P＜0.05).TSK-SV Heart scores were significantly higher and HH-SESM scores were significantly lower in the MACE group as compared with the non-MACE group(P＜0.05).Pearson correlation analysis showed a negative correlation between TSK-SV Heart and HH-SESM scores(r=-0.192,P＜0.05).ROC analy-sis revealed area unoler the curve(AUC)values of 0.892(0.851-0.933)for TSK-SV Heart scores,0.962(0.937-0.989)for HH-SESM scores,and 0.986(0.965-0.997)for their combination.HH-SESM scores alone and combined demonstra-ted superior predictive efficacy versus TSK-SV Heart scores alone(Z=5.782,7.214;P=0.016,0.004).Multivariate a-nalysis identified TSK-SV Heart scores≥38.01(OR=2.102,95％CI:1.504-2.939)and HH-SESM scores＜49.98(OR=0.556,95％CI:0.423-0.730)as influencing factors of MACE(P＜0.05).Conclusion TSK-SV Heart and HH-SESM scores closely associate with MACE in SCAD patients.Combined assessment provides superior predictive value ver-sus either measure alone.Enhanced risk factor monitoring and dynamic evaluation of kinesiophobia,self-efficacy,and self-management are crucial for early identification and targeted intervention in high-risk patients of MACE.