Cited by 182Cardiac Health and Mental HealthCardiac Imaging and DiagnosticsAcute Myocardial Infarction Research

Anxiety worsens prognosis in patients with coronary artery disease

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Shibeshi, Woldecherkos A., Young-Xu, Yinong, Blatt, Charles M.·2007·Journal of the American College of Cardiology

Abstract

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.

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Crossref · 10.1016/j.jacc.2007.03.007

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  1. Kellner R, Sheffield BF. Improving criteria for drug trial with neurotic patients. Psychol Med 1971;1:416 -25.
  2. Ahern DK, Gorkin L, Anderson JL. Biobehavioural variables and mortality/cardiac arrest in the cardiac arrhythmia pilot study. Am J Cardiol 1990;66:59 -62.

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Authors
Shibeshi, W. A., Young-Xu, Y., & Blatt, C. M.
Affiliations
Harvard University (US)
Corresponding author
Blatt, Charles M.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2007-05
Volume
49
Issue
20
Pages
2021-2027
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2083656511
Cited by
182
References
47
Citations by year
2026: 2 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 5 · 2021: 11 · 2020: 12 · 2019: 10 · 2018: 7 · 2017: 8 · 2016: 14 · 2015: 7 · 2014: 10 · 2013: 12 · 2012: 14
FWCI
8.18
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
anxiety, coronary artery disease, myocardial infarction, all-cause mortality, prognosis, cardiovascular risk factors
MeSH terms
Aged, Anxiety, Coronary Artery Disease, Female, Follow-Up Studies, Humans, Male, Massachusetts, Myocardial Infarction, Prognosis, Prospective Studies, Surveys and Questionnaires, Multivariate Analysis

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