Is a clinical diagnosis of an anxiety disorder associated with coronary endothelial dysfunction in patients with chest pain and nonobstructive coronary artery disease?
Anxiety disorders are significantly associated with coronary endothelial dysfunction in women with chest pain and nonobstructive CAD, suggesting a potential mechanism linking anxiety to cardiovascular events.
Background Anxiety disorders are the most prevalent mental disorders and are an emerging risk factor for coronary artery disease and its complications. We determine the relationship between having a clinical diagnosis of an anxiety disorder and coronary endothelial dysfunction (CED) using invasive coronary reactivity testing across both sexes. Methods and Results Patients presenting with chest pain and nonobstructive coronary artery disease (stenosis P=0.011) that persisted in women but not in men. After adjusting for covariables, anxiety was significantly associated with any CED among all patients (odds ratio 95% CI, 1.36 1.10-1.68; P=0.004), and after stratifying by sex in women but not in men. Conclusions Anxiety disorders are significantly associated with CED in women presenting with chest pain and nonobstructive coronary artery disease. Thus, CED may represent a mechanism underpinning the association between anxiety disorders and coronary artery disease and its complications, highlighting the role of anxiety as a potential therapeutic target to prevent cardiovascular events.
Sara et al. (Sat,) studied this question.