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Anxiety Worsens Prognosis in Patients With Coronary Artery Disease
Open accessAbstract
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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“and generalized, phobic anxiety, and panic attacks may worsen the course of established CVD (OR 1.01 and 2.0, respectively).107 -109”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [108]
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Metadata
- 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
- bronze
- doi.org
- Licence
- 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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