Ming-Yow Hung1, Chun-Tai Mao, Ming-Jui Hung, Jiunn-Kae Wang, Hsin-Chien Lee, Chi-Tai Yeh, Patrick Hu, Tien-Hsing Chen, Nen-Chung Chang. 1. From the Division of Cardiology (Hung), Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Internal Medicine (Hung), School of Medicine, College of Medicine, Taipei Medical University, Taipei City; Division of Cardiology (Mao, Hung, Chen), Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Chang Gung University College of Medicine, Taoyuan; Department of Psychiatry (Wang, Lee), Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Psychiatry (Wang, Lee), School of Medicine, College of Medicine, Taipei Medical University, Taipei City; Department of Medical Research and Education (Yeh), Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; University of California (Hu), Riverside; Department of Cardiology (Hu), Riverside Medical Clinic, California; and Division of Cardiology (Chang), Department of Internal Medicine, Taipei Medical University Hospital, Taiwan.
Abstract
OBJECTIVE: Anxiety and depression are risk factors for obstructive coronary artery disease (CAD), but their effects on coronary artery spasm (CAS) remain unestablished. METHODS: Patient records in this population-based study were retrospectively collected from the Taiwan National Health Insurance Research Database. Using propensity score matching, we used 1:1:1 ratio stratification into a control group of 10,325 individuals without CAS or CAD, a CAS group comprising 10,473 patients, and a CAD group comprising 10,473 patients during 2000-2012. RESULTS: The prevalence of CAS and CAD was 0.067% and 8.7%, respectively, in the general population. The prevalence of anxiety and depression diagnoses was significantly higher in patients with new-onset CAS than in those with new-onset CAD and controls without CAS/CAD, even after propensity score matching. Compared with CAD, anxiety and depression diagnoses conferred a higher risk of developing CAS (odds ratio [OR] = 2.29, 95% confidence interval [CI], 2.14-2.45, p < .001, and OR = 1.34, 95% CI, 1.08-1.66, p = .007, respectively). The association was even stronger when comparing CAS with the control group without CAD or CAS (OR = 5.20, 95% CI, 4.72-5.74, p < .001, and OR = 1.98, 95% CI, 1.50-2.62, p < .001, respectively). The increased risk of new-onset CAS as related to previous anxiety and depression diagnoses was comparable between males and females. CONCLUSIONS: Compared with CAD or the general population, anxiety and depression diagnoses confer a higher risk of developing CAS. No sex differences are found for the association of anxiety and depression with CAS.
OBJECTIVE:Anxiety and depression are risk factors for obstructive coronary artery disease (CAD), but their effects on coronary artery spasm (CAS) remain unestablished. METHODS:Patient records in this population-based study were retrospectively collected from the Taiwan National Health Insurance Research Database. Using propensity score matching, we used 1:1:1 ratio stratification into a control group of 10,325 individuals without CAS or CAD, a CAS group comprising 10,473 patients, and a CAD group comprising 10,473 patients during 2000-2012. RESULTS: The prevalence of CAS and CAD was 0.067% and 8.7%, respectively, in the general population. The prevalence of anxiety and depression diagnoses was significantly higher in patients with new-onset CAS than in those with new-onset CAD and controls without CAS/CAD, even after propensity score matching. Compared with CAD, anxiety and depression diagnoses conferred a higher risk of developing CAS (odds ratio [OR] = 2.29, 95% confidence interval [CI], 2.14-2.45, p < .001, and OR = 1.34, 95% CI, 1.08-1.66, p = .007, respectively). The association was even stronger when comparing CAS with the control group without CAD or CAS (OR = 5.20, 95% CI, 4.72-5.74, p < .001, and OR = 1.98, 95% CI, 1.50-2.62, p < .001, respectively). The increased risk of new-onset CAS as related to previous anxiety and depression diagnoses was comparable between males and females. CONCLUSIONS: Compared with CAD or the general population, anxiety and depression diagnoses confer a higher risk of developing CAS. No sex differences are found for the association of anxiety and depression with CAS.