Anxiety and adverse coronary artery disease outcomes in Chinese patients
Gaofeng Wang1, Jianguo Cui, Yanping Wang
1Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Insights
Anxiety in Chinese Han patients with coronary artery disease (CAD) correlates with atherosclerosis severity. Anxiety independently predicts worse prognosis, including death and nonfatal myocardial infarction (MI).
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Coronary artery disease (CAD) poses a significant health burden globally.
- Anxiety is a common comorbidity in patients with cardiovascular conditions.
- The impact of anxiety on CAD prognosis in specific ethnic groups requires further investigation.
Purpose of the Study:
- To examine the relationship between anxiety and coronary atherosclerosis severity.
- To determine if anxiety predicts adverse outcomes in Chinese Han patients with CAD.
- To explore the prognostic value of anxiety in this population.
Main Methods:
- 1007 hospitalized CAD patients underwent assessment using the Zung Self-Rating Anxiety Scale.
- Coronary atherosclerosis severity was quantified using the modified Gensini score.
- A composite outcome of all-cause death and nonfatal myocardial infarction (MI) was tracked over 1.5 years.
Main Results:
- Anxiety scores significantly correlated with the Gensini score (β = 1.35, p < .001).
- Anxiety independently predicted a composite of all-cause death and nonfatal MI (adjusted hazard ratio = 2.43, p = .009).
- A total of 917 patients were evaluated over a mean 17-month follow-up.
Conclusions:
- Anxiety is independently associated with coronary atherosclerosis severity in Chinese Han CAD patients.
- Anxiety serves as a significant predictor of worse prognosis, including mortality and MI.
- These findings highlight the importance of addressing anxiety in CAD management for this demographic.
Objectives:
To investigate the impact of anxiety on the prognosis of coronary artery disease (CAD) in patients of Chinese Han ethnicity and to explore the correlation between anxiety and the severity of coronary atherosclerosis.
Methods:
Between June 2007 and May 2009, 1007 hospitalized patients with CAD diagnosed by coronary angiography were recruited. The anxiety symptoms were investigated within 2 days after coronary angiography or percutaneous coronary intervention, using the Zung Self-Rating Anxiety Scale. The severity of coronary atherosclerosis was assessed using the modified Gensini score. One and a half years after discharge, the participants were evaluated at the outpatient clinic or by telephone. The primary outcome was the composite of all-cause death and nonfatal myocardial infarction (MI).
Results:
A total of 917 (91.1%) patients were evaluated during a mean follow-up period of 17 months. Thirty-five deaths (26 of cardiovascular and 9 of other causes) and 5 nonfatal MIs occurred. The Zung Self-Rating Anxiety Scale score assessed during hospitalization was significantly and independently associated with the Gensini score (β = 1.35, p < .001). Adjusted Cox proportional hazards models showed that anxiety symptoms predicted all-cause death and nonfatal MI (adjusted hazard ratio = 2.43, 95% confidence interval = 1.24-4.75, p = .009).
Conclusions:
Anxiety was independently associated with the severity of coronary atherosclerosis and predicted worse outcome in patients with CAD of Chinese Han ethnicity.
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