OBJECTIVES: This study examined the effect of anxiety on mortality and nonfatal myocardial infarction (MI) in patients with coronary artery disease (CAD). BACKGROUND: Inconsistent data exist regarding the impact of anxiety on the prognosis of patients with CAD. METHODS: The authors conducted a prospective cohort study at an outpatient cardiology clinic of 516 patients with CAD (mean age 68 years at entry, 82% male) by administering the Kellner Symptom Questionnaire annually. The primary outcome was the composite of nonfatal MI or all-cause mortality. RESULTS: During an average follow-up of 3.4 years, we documented 44 nonfatal MIs and 19 deaths. A high cumulative anxiety score was associated with an increased risk of nonfatal MI or death. Comparing the highest to lowest tertile of anxiety score, the age-adjusted hazard ratio was 1.97 (95% confidence interval 1.03 to 3.78, p = 0.04). In a multivariate Cox model after adjusting for age, gender, education, marital status, smoking, hypertension, diabetes mellitus, previous MI, body mass index, and total cholesterol, each unit increase in the cumulative mean anxiety score was associated with increased risk of nonfatal MI or total mortality; the hazard ratio was 1.06 (95% confidence interval 1.01 to 1.12, p = 0.02). CONCLUSIONS: A high level of anxiety maintained after CAD diagnosis constitutes a strong risk of MI or death among patients with CAD.
OBJECTIVES: This study examined the effect of anxiety on mortality and nonfatal myocardial infarction (MI) in patients with coronary artery disease (CAD). BACKGROUND: Inconsistent data exist regarding the impact of anxiety on the prognosis of patients with CAD. METHODS: The authors conducted a prospective cohort study at an outpatient cardiology clinic of 516 patients with CAD (mean age 68 years at entry, 82% male) by administering the Kellner Symptom Questionnaire annually. The primary outcome was the composite of nonfatal MI or all-cause mortality. RESULTS: During an average follow-up of 3.4 years, we documented 44 nonfatal MIs and 19 deaths. A high cumulative anxiety score was associated with an increased risk of nonfatal MI or death. Comparing the highest to lowest tertile of anxiety score, the age-adjusted hazard ratio was 1.97 (95% confidence interval 1.03 to 3.78, p = 0.04). In a multivariate Cox model after adjusting for age, gender, education, marital status, smoking, hypertension, diabetes mellitus, previous MI, body mass index, and total cholesterol, each unit increase in the cumulative mean anxiety score was associated with increased risk of nonfatal MI or total mortality; the hazard ratio was 1.06 (95% confidence interval 1.01 to 1.12, p = 0.02). CONCLUSIONS: A high level of anxiety maintained after CAD diagnosis constitutes a strong risk of MI or death among patients with CAD.
Authors: Jerome L Fleg; Daniel E Forman; Kathy Berra; Vera Bittner; James A Blumenthal; Michael A Chen; Susan Cheng; Dalane W Kitzman; Mathew S Maurer; Michael W Rich; Win-Kuang Shen; Mark A Williams; Susan J Zieman Journal: Circulation Date: 2013-10-28 Impact factor: 29.690
Authors: Thomas Rutledge; Sarah E Linke; David S Krantz; B Delia Johnson; Vera Bittner; Jo-Ann Eastwood; Wafia Eteiba; Carl J Pepine; Viola Vaccarino; Jennifer Francis; Diane A Vido; C Noel Bairey Merz Journal: Psychosom Med Date: 2009-10-15 Impact factor: 4.312
Authors: M Urooj Zafar; Manuel Paz-Yepes; Daichi Shimbo; Gemma Vilahur; Matthew M Burg; William Chaplin; Valentin Fuster; Karina W Davidson; Juan J Badimon Journal: Eur Heart J Date: 2010-01-22 Impact factor: 29.983