Key result
Somatic anxiety symptoms following acute myocardial infarction were significantly associated with an increased risk of recurrent MI and all-cause mortality (HR 1.32).
Why the study?
Do somatic and psychological symptoms of anxiety predict recurrent MI and all-cause mortality in patients following acute myocardial infarction?
Cohort (n=418)
Yes
Do somatic and psychological symptoms of anxiety predict recurrent MI and all-cause mortality in patients following acute myocardial infarction?
Hazard Ratio: 1.32 (95% CI 1.03–1.69)
p-value: p=0.03
Somatic anxiety and total anxiety symptoms measured 2 months post-MI are significant independent predictors of recurrent MI and all-cause mortality.
May warrant post-MI somatic anxiety screening; extends observational risk data but leaves intervention effects open.
OBJECTIVE: Differential associations of symptom dimensions with prognosis in myocardial infarction (MI) patients have been shown for depression, but no studies have focused on anxiety dimensions. The aim of this study was to assess the association between somatic and psychological symptoms of anxiety following acute MI with adverse prognosis and to assess the overlap between anxiety and depression dimensions. METHOD: Patients (n = 418) were assessed on demographic and clinical variables. The Hamilton Anxiety and Depression Rating Scales were used to measure anxiety and depression 2 months post-MI. Mean follow-up period was 3.8 years and the endpoint consisted of all-cause mortality and recurrent MI. RESULTS: After adjustment for demographic and clinical variables, somatic anxiety was significantly associated with recurrent MI and mortality (HR: 1.32; 95% CI [1.03, 1.69]; p = .03), and a trend was shown for an association between psychological anxiety and outcome (HR: 1.29; 95% CI [0.99, 1.67]; p = .06). The total anxiety score of the HARS was the strongest predictor of recurrent MI and mortality (HR: 1.38; 95% CI [1.07, 1.78]; p = .02). The HARS and the HDRS were highly correlated (r = .86; p < .01). Dimensions consisting of psychological distress (HR: 1.29; 95% CI [1.02, 1.63]; p = .03) and cardiopulmonary/autonomic symptoms (HR: 1.36; 95% CI [1.06, 1.75]; p = .02) also predicted outcome in adjusted analyses. CONCLUSIONS: Anxiety was associated with adverse prognosis in MI patients with significant associations for somatic anxiety and total anxiety. When combining anxiety and depression items, psychological distress and cardiopulmonary/autonomic symptoms predicted recurrent MI and mortality. Future research might better focus on dimensions of anxiety and depression simultaneously in MI patients.
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Roest et al. (2013) conducted a cohort in Acute myocardial infarction (n=418). Somatic anxiety symptoms vs. Lower somatic anxiety symptom levels was evaluated on Composite of all-cause mortality and recurrent MI (HR 1.32, 95% CI 1.03-1.69, p=0.03). Somatic anxiety symptoms following acute myocardial infarction were significantly associated with an increased risk of recurrent MI and all-cause mortality (HR 1.32).
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