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Association between anxiety and clinical outcomes in Chinese patients with myocardial infarction in the absence of obstructive coronary artery disease.

Research paper by Chao-Jie CJ He, Chun-Yan CY Zhu, Bin B Han, Hai-Zhen HZ Hu, Shi-Jun SJ Wang, Chang-Lin CL Zhai, Hui-Lin HL Hu

Indexed on: 10 Jun '20Published on: 10 Jun '20Published in: Clinical Cardiology



Abstract

Myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) accounts for approximately 5% - 6% of acute myocardial infarction (AMI) patients. Anxiety symptoms are common in patients with coronary artery disease (CAD), and are associated with a poor prognosis. However, the association between anxiety and MINOCA outcomes is less clear. Anxiety will be associated with clinical outcomes in patients with MINOCA. Between November 2014 and December 2016, 620 hospitalized patients with MINOCA were recruited from a single center. Within 7 days of coronary angiography, anxiety was assessed using the Zung Self-Rating Anxiety Scale. The primary endpoint was all-cause mortality; secondary endpoint was any major adverse cardiovascular event (MACE). After 3 years, 87 deaths and 151 MACE had occurred. Kaplan-Meier curves indicated the unadjusted rates of all-cause mortality (log-rank P = .045) and MACE (log-rank P = .023) were significantly higher in the anxiety group compared with the control group of patients without anxiety. Multivariate Cox regression analysis showed that clinically significant anxiety was an independent prognostic factor for all-cause mortality as well as MACE (hazard ratio [HR] = 1.547; 95% confidence interval [CI], 1.006-2.380; P = .047; HR = 1.460; 95% CI, 1.049-2.031; P = .025; respectively). Anxiety is significantly and independently associated with an increased risk of all-cause mortality and MACE in patients with MINOCA. © 2020 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.

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