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Coronary Artery Spasm as Related to Anxiety and Depression: A Nationwide Population-Based Study

Ming-Yow Hung1, Chun-Tai Mao, Ming-Jui Hung

  • 1From the Division of Cardiology (Hung), Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Internal Medicine (Hung), School of Medicine, College of Medicine, Taipei Medical University, Taipei City; Division of Cardiology (Mao, Hung, Chen), Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Chang Gung University College of Medicine, Taoyuan; Department of Psychiatry (Wang, Lee), Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Psychiatry (Wang, Lee), School of Medicine, College of Medicine, Taipei Medical University, Taipei City; Department of Medical Research and Education (Yeh), Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; University of California (Hu), Riverside; Department of Cardiology (Hu), Riverside Medical Clinic, California; and Division of Cardiology (Chang), Department of Internal Medicine, Taipei Medical University Hospital, Taiwan.

Psychosomatic Medicine
|January 18, 2019
PubMed

Insights

Anxiety and depression significantly increase the risk of developing coronary artery spasm (CAS), even more so than coronary artery disease (CAD). These mental health conditions pose a notable risk for CAS development in both men and women.

Area of Science:

  • Cardiology
  • Psychiatry
  • Epidemiology

Background:

  • Anxiety and depression are known risk factors for obstructive coronary artery disease (CAD).
  • The specific impact of anxiety and depression on coronary artery spasm (CAS) has not been well-established.
  • Understanding these associations is crucial for comprehensive cardiovascular risk assessment.

Purpose of the Study:

  • To investigate the association between anxiety and depression and the risk of developing coronary artery spasm (CAS).
  • To compare the risk conferred by anxiety and depression for CAS versus obstructive CAD.
  • To examine potential sex differences in the association between anxiety, depression, and CAS.

Main Methods:

  • Retrospective analysis of patient records from the Taiwan National Health Insurance Research Database (2000-2012).
  • Utilized propensity score matching for 1:1:1 ratio stratification into control, CAS, and CAD groups.
  • Included 10,325 controls, 10,473 CAS patients, and 10,473 CAD patients.

Main Results:

  • The prevalence of CAS and CAD in the general population was 0.067% and 8.7%, respectively.
  • Anxiety and depression diagnoses were significantly more prevalent in new-onset CAS patients compared to CAD patients and controls.
  • Anxiety and depression conferred a higher risk for developing CAS (OR=2.29 for anxiety vs CAD; OR=5.20 for anxiety vs controls) than for CAD.

Conclusions:

  • Anxiety and depression diagnoses are associated with a significantly higher risk of developing coronary artery spasm (CAS) compared to coronary artery disease (CAD) or the general population.
  • The increased risk of CAS associated with anxiety and depression was consistent across both male and female populations.
  • These findings highlight the importance of considering mental health status in the risk stratification for coronary artery spasm.
Abstract

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