From heart to mind: research advances in the link between coronary artery disease and mental stress-A narrative review

Abstract Mental stress, a significant risk factor for coronary artery disease (CAD), has garnered widespread attention in recent years. Numerous studies indicate a close link between the development of CAD and mental stress. Mental stress can trigger acute coronary events and worsen CAD via vascular inflammation, endothelial dysfunction, coagulation cascade, and neuro-endocrine-immune response. Additionally, a bidirectional link exists between mental stress and CAD, leading to a vicious cycle that further hinders recovery from the disease. Therefore, early detection, diagnosis, and intervention for mental stress, combined with mental stress management alongside standard CAD treatments, is crucial to effectively breaking this vicious cycle. This narrative review examines the current state of research on the link between mental stress and CAD, examining how mental stress influences the onset, progression, and prognosis of CAD. It aims to emphasize the necessity of early identification and comprehensive management of mental stress to improve patient outcomes and prevent disease progression. It also recommends psycho-cardiology therapy in treatment plans and proposes an innovative model for early screening, diagnosis, and intervention.