Abstract: Objective  To explore the influence of family stress on the prognosis of patients with  acute coronary syndrome  (ACS) in different gender,  so that providing evidences for different groups of people to develop appropriate rehabilitation and behavioral interventions. Methods  A total of 109 patients with acute coronary syndrome (ACS) for the first episode were enrolled in this study. Demographic and clinical data of patients were collected. The family stress,  burnout,  anxiety and depression at baseline were evaluated by Family Stress Scale (FSS),  General Burnout Subscale of Copenhagen Burnout Inventory,  and Hospital Anxiety and Depression Scale  respectively,  one day before their discharge. All patients were followed up one month after discharge. Their physical performance and quality of life were evaluated by Short Physical Performance Battery (SPPB) and 8item short form generic healthrelated qualityoflife questionnaire (SF8)  respectively. Then they were stratified according to different  gender. The effects of baseline family stress on physical performance (SPPB score),  SF8 physical health score and mental health score were analyzed. Results    The baseline family stress of the total sample was not related to the SPPB score,  but negatively related to the physical health score and mental health score,  one month after discharge. In female group,  baseline family stress was not correlated with SPPB,  physical health score and mental health score. While in male group,  baseline family stress was negatively correlated with SPPB score,  physical health score and mental health score. Multiple linear regression models were developed to control confounding factors in male group.  The effects of many confounding factors including age,  smoking,  drinking,  past medical history,  depression/burnout at baseline and so on,  were excluded. Then the results showed that baseline family stress of male had an impact on the SPPB score,  physical and mental health score one month after discharge. Conclusion  Male ACS patients with high family stress had poor physical strength and low quality of life one month after onset,  but there were no such effects in female patients,  suggesting that the impact of family stress on the prognosis of ACS patients may have gender differences.

Key words: acute coronary syndrome, family stress, gender difference