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Does Anxiety Affect Survival in Patients with Coronary Heart Disease?
Introduction: Behavioral and physiological risk factors worsen the prognosis of coronary heart disease (CHD). Anxiety is known to be a psychological predictor of CHD. In this study, we investigated whether this factor is associated with all-cause mortality in CHD patients in the long term. Methods:...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052991/ https://www.ncbi.nlm.nih.gov/pubmed/36983102 http://dx.doi.org/10.3390/jcm12062098 |
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author | Deter, Hans-Christian Albert, Wolfgang Weber, Cora Merswolken, Melanie Orth-Gomér, Kristina Herrmann-Lingen, Christoph Grün, Anna-Sophia |
author_facet | Deter, Hans-Christian Albert, Wolfgang Weber, Cora Merswolken, Melanie Orth-Gomér, Kristina Herrmann-Lingen, Christoph Grün, Anna-Sophia |
author_sort | Deter, Hans-Christian |
collection | PubMed |
description | Introduction: Behavioral and physiological risk factors worsen the prognosis of coronary heart disease (CHD). Anxiety is known to be a psychological predictor of CHD. In this study, we investigated whether this factor is associated with all-cause mortality in CHD patients in the long term. Methods: We studied 180 patients (mean age 60.6 SD 9.2 years, 26% women) with CHD from the Berlin Anxiety Trial (BAT) and the Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD) study. Their cardiac and psychological risk profile was represented by standardized procedures, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. Mortality outcomes were assessed using a community-based registry. Results: Of 180 patients, we obtained information on all-cause mortality in 175 (96.7%) after a mean follow-up of 12.2 years (range 10.4–16.6 years). Of all participants, 54.4% had prior myocardial infarction, 95.3% had percutaneous transluminal coronary angioplasty and 22.2% had prior coronary artery bypass graft. Most of the patients (98.4%) had New York Heart Association class I and II, 25.6% had diabetes and 38.2% were smokers. Patients had a mean HADS anxiety score of 9.7 SD 4.1 at study entrance. We found the highest HADS anxiety quartile all-cause mortality in 14%, 30.2% in the middle quartiles and 58.7% in the lowest quartile (chi(2) 20.8, p = 0.001). Related to psychological mechanisms, a low level of anxiety, seemed to be a significant predictor of all-cause mortality. We found no advantage for patients who had received psychosocial therapy in terms of survival. Conclusion: These first data confirmed our hypothesis about the association of psychological risk factors with the long-term outcome of CAD patients. Future studies will clarify whether the severity of disease, age or a particular type of coping or denial mechanism are associated with the presented outcome in low-anxious patients. |
format | Online Article Text |
id | pubmed-10052991 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100529912023-03-30 Does Anxiety Affect Survival in Patients with Coronary Heart Disease? Deter, Hans-Christian Albert, Wolfgang Weber, Cora Merswolken, Melanie Orth-Gomér, Kristina Herrmann-Lingen, Christoph Grün, Anna-Sophia J Clin Med Article Introduction: Behavioral and physiological risk factors worsen the prognosis of coronary heart disease (CHD). Anxiety is known to be a psychological predictor of CHD. In this study, we investigated whether this factor is associated with all-cause mortality in CHD patients in the long term. Methods: We studied 180 patients (mean age 60.6 SD 9.2 years, 26% women) with CHD from the Berlin Anxiety Trial (BAT) and the Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD) study. Their cardiac and psychological risk profile was represented by standardized procedures, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. Mortality outcomes were assessed using a community-based registry. Results: Of 180 patients, we obtained information on all-cause mortality in 175 (96.7%) after a mean follow-up of 12.2 years (range 10.4–16.6 years). Of all participants, 54.4% had prior myocardial infarction, 95.3% had percutaneous transluminal coronary angioplasty and 22.2% had prior coronary artery bypass graft. Most of the patients (98.4%) had New York Heart Association class I and II, 25.6% had diabetes and 38.2% were smokers. Patients had a mean HADS anxiety score of 9.7 SD 4.1 at study entrance. We found the highest HADS anxiety quartile all-cause mortality in 14%, 30.2% in the middle quartiles and 58.7% in the lowest quartile (chi(2) 20.8, p = 0.001). Related to psychological mechanisms, a low level of anxiety, seemed to be a significant predictor of all-cause mortality. We found no advantage for patients who had received psychosocial therapy in terms of survival. Conclusion: These first data confirmed our hypothesis about the association of psychological risk factors with the long-term outcome of CAD patients. Future studies will clarify whether the severity of disease, age or a particular type of coping or denial mechanism are associated with the presented outcome in low-anxious patients. MDPI 2023-03-07 /pmc/articles/PMC10052991/ /pubmed/36983102 http://dx.doi.org/10.3390/jcm12062098 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Deter, Hans-Christian Albert, Wolfgang Weber, Cora Merswolken, Melanie Orth-Gomér, Kristina Herrmann-Lingen, Christoph Grün, Anna-Sophia Does Anxiety Affect Survival in Patients with Coronary Heart Disease? |
title | Does Anxiety Affect Survival in Patients with Coronary Heart Disease? |
title_full | Does Anxiety Affect Survival in Patients with Coronary Heart Disease? |
title_fullStr | Does Anxiety Affect Survival in Patients with Coronary Heart Disease? |
title_full_unstemmed | Does Anxiety Affect Survival in Patients with Coronary Heart Disease? |
title_short | Does Anxiety Affect Survival in Patients with Coronary Heart Disease? |
title_sort | does anxiety affect survival in patients with coronary heart disease? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052991/ https://www.ncbi.nlm.nih.gov/pubmed/36983102 http://dx.doi.org/10.3390/jcm12062098 |
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