Yuichi Saito1, Toshihiro Shoji2,3, Kazuya Tateishi2, Hideki Kitahara2, Yoshihide Fujimoto2, Yoshio Kobayashi2. 1. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan. saitoyuichi1984@gmail.com. 2. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan. 3. Department of Internal Medicine, Chiba Aoba Municipal Hospital, Chiba, Japan.
Abstract
BACKGROUND: Previous studies showed the relation of mental distress such as anxiety and depression to coronary vasoconstriction and myocardial ischemia. However, the mental health status of patients suspected to have vasospastic angina is unclear. METHODS: A total of 99 patients underwent intracoronary acetylcholine (ACh) provocation tests for the diagnosis of vasospastic angina and mental health assessment using the 12-item General Health Questionnaire (GHQ-12) and State-Trait Anxiety Inventory Form Y (STAI Y-2). Patients with binary GHQ-12 ≥ 4 were defined as having poor mental health. RESULTS: Median GHQ-12 and STAI Y-2 were 3 [1, 6] and 44 [36, 50]. Forty-one (41%) patients had binary GHQ-12 ≥ 4, and 48 (48%) had positive ACh provocation tests. The number of provoked vasospasms and rate of electrocardiographic change and chest pain during ACh tests were not significantly different between patients with and without GHQ-12 ≥ 4. The incidence of positive ACh provocation test was similar between the two groups (49% vs. 48%, p = 1.00). The multivariable analysis indicated that younger age, no history of percutaneous coronary intervention and no diabetes mellitus were factors associated with higher GHQ-12 and/or STAI Y-2 scores. CONCLUSIONS: More than 40% of patients who underwent ACh provocation tests had poor mental condition. No impact of mental distress on positive ACh tests was found in this study.
BACKGROUND: Previous studies showed the relation of mental distress such as anxiety and depression to coronary vasoconstriction and myocardial ischemia. However, the mental health status of patients suspected to have vasospastic angina is unclear. METHODS: A total of 99 patients underwent intracoronary acetylcholine (ACh) provocation tests for the diagnosis of vasospastic angina and mental health assessment using the 12-item General Health Questionnaire (GHQ-12) and State-Trait Anxiety Inventory Form Y (STAI Y-2). Patients with binary GHQ-12 ≥ 4 were defined as having poor mental health. RESULTS: Median GHQ-12 and STAI Y-2 were 3 [1, 6] and 44 [36, 50]. Forty-one (41%) patients had binary GHQ-12 ≥ 4, and 48 (48%) had positive ACh provocation tests. The number of provoked vasospasms and rate of electrocardiographic change and chest pain during ACh tests were not significantly different between patients with and without GHQ-12 ≥ 4. The incidence of positive ACh provocation test was similar between the two groups (49% vs. 48%, p = 1.00). The multivariable analysis indicated that younger age, no history of percutaneous coronary intervention and no diabetes mellitus were factors associated with higher GHQ-12 and/or STAI Y-2 scores. CONCLUSIONS: More than 40% of patients who underwent ACh provocation tests had poor mental condition. No impact of mental distress on positive ACh tests was found in this study.
Authors: Muhammad Hammadah; Jeong Hwan Kim; Ibhar Al Mheid; Ayman Samman Tahhan; Kobina Wilmot; Ronnie Ramadan; Ayman Alkhoder; Mohamed Khayata; Girum Mekonnen; Oleksiy Levantsevych; Yasir Bouchi; Belal Kaseer; Fahad Choudhary; Mohamad M Gafeer; Frank E Corrigan; Amit J Shah; Laura Ward; Michael Kutner; J Douglas Bremner; David S Sheps; Paolo Raggi; Viola Vaccarino; Habib Samady; Kreton Mavromatis; Arshed A Quyyumi Journal: J Am Heart Assoc Date: 2018-05-03 Impact factor: 5.501