Key result
Elevated anxiety scores linked to ~140% higher odds of CSX versus healthy controls.
Why the study?
Patients with cardiac syndrome X may have increased levels of anxiety and depression compared to healthy controls, but this relationship requires clarification.
Do patients with Cardiac Syndrome X have higher levels of anxiety and depression compared to healthy controls?
Case-Control (n=210)
Do patients with Cardiac Syndrome X have higher levels of anxiety and depression compared to healthy controls?
Odds Ratio: 2.399 (95% CI 1.248–4.613)
p-value: p=0.009
Patients with Cardiac Syndrome X exhibit significantly higher levels of anxiety and depression compared to healthy controls, highlighting the potential benefit of psychological support in this population.
May support anxiety screening in CSX; hypothesis-generating for interventions pending prospective trials.
OBJECTIVE: Cardiac syndrome X (CSX) is defined as angina-like symptoms, abnormalities on stress testing, and normal epicardial coronary arteries on coronary angiography. The aim of this study was to determine the Hospital Anxiety and Depression scores of patients with CSX and to compare with healthy controls. Materials/Subjects and Methods: Patients undergoing coronary angiography between January 2015 and December 2016 because of clinical indications, including abnormal noninvasive test results were examined. Two hundred and 10 subjects (110 patients with CSX, 100 controls) were enrolled. Demographic characteristics including age, education level, marriage status, and history of stressful life events were recorded. The Turkish version of the Hospital Anxiety and Depression scale was evaluated in the study population. RESULTS: Anxiety, depression, and total scores in the patients with CSX were significantly higher than those in the control group (p < 0.001, p < 0.003, p < 0.001, respectively). Among women, anxiety, depression, total scores, and stressful life events were significantly higher in the CSX group (p = 0.006, p = 0.015, p = 0.001, p < 0.001, respectively). Patients with lower educational status had higher anxiety scores (p = 0.03), stressful life events, and HAD-A > 10 were the only independent predictors of CSX in logistic regression analysis with comparable ORs 2.256 (95% CI 1.057-4.817, p = 0.03) and 2,399 (95% CI 1.248-4.613, p = 0.009) respectively. CONCLUSION: The results of our research suggest that patients with CSX have a high prevalence of stress and psychiatric disturbances. Interventions targeted toward improving the quality of life and to give psychological support may have the potential benefits especially for women and individuals with lower education.
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Çekirdekçi et al. (2018) conducted a case-control in Cardiac syndrome X (n=210). Cardiac syndrome X vs. Healthy controls was evaluated on Hospital Anxiety and Depression scores (HAD-A > 10 as a predictor of CSX) (OR 2.399, 95% CI 1.248-4.613, p=0.009). Cardiac syndrome X was associated with significantly higher anxiety and depression scores compared to healthy controls, with an anxiety score >10 independently predicting CSX (OR 2.399; 95% CI 1.248-4.613).
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