Background and aim: We aimed to evaluate the prevalence and determinants of different stress coping strategies in Polish patients suffering from heart failure with reduced ejection fraction (HFREF).

Methods: This manuscript is a sub-study of the CAPS-LOCK-HF multicentre psychological status assessment of patients with HFREF. Patients with > six-month history of HFREF and clinical stability for ≥ three months and left ventricular ejection fraction (LVEF) < 45% were enrolled in the study. Demographic and clinical variables were obtained from medical records, while a standardised Coping Inventory for Stressful Situations (CISS) was applied to all subjects.

Results: The study comprised 758 patients (599 men; 79%) with a median age of 64 years (IQR 58–71). Median LVEF was 33% (25–40). Subjects most commonly used task-oriented coping strategies (median CISS score 55 points; IQR 49–61), followed by avoidance (45 points; 39–50) and emotion-oriented coping strategies (41 points; 34–48). Distraction-based avoidance coping strategies (20 points; 16–23) were more pronounced than social diversion strategies (16 points; 14–19). Multiple regression analysis showed that higher New York Heart Association (NYHA) class and lower systolic blood pressure were independent predictors of task-oriented style. Emotion-oriented coping was more common among females and higher NYHA classes, and in patients who did not take angiotensin-converting enzyme inhibitors. Patients who used avoidance-oriented strategies were more frequently those in sinus rhythm on assessment and those who had less history of neoplastic disease.

Conclusions: Patients with HFREF most commonly use favourable task-oriented coping strategies. However, female patients and those with higher NYHA classes tend to use potentially detrimental emotion-oriented coping strategies.