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Myocardial infarction and generalised anxiety disorder: 10-year follow-up

  • Annelieke M. Roest (a1), Marij Zuidersma (a1) and Peter de Jonge (a2)
Abstract
Background

Few studies have addressed the relationship between generalised anxiety disorder and cardiovascular prognosis using a diagnostic interview.

Aims

To assess the association between generalised anxiety disorder and adverse outcomes in patients with myocardial infarction.

Method

Patients with acute myocardial infarction (n = 438) were recruited between 1997 and 2000 and were followed up until 2007. Current generalised anxiety disorder and post-myocardial infarction depression were assessed with the Composite International Diagnostic Interview. The end-point consisted of all-cause mortality and cardiovascular-related readmissions.

Results

During the follow-up period, 198 patients had an adverse event. Generalised anxiety disorder was associated with an increased rate of adverse events after adjustment for age and gender (hazard ratio: 1.94; 95% confidence interval: 1.14–3.30; P = 0.01). Additional adjustment for measures of cardiac disease severity and depression did not change the results.

Conclusions

Generalised anxiety disorder was associated with an almost twofold increased risk of adverse outcomes independent demographic and clinical variables and depression.

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Copyright
Corresponding author
Peter de Jonge, Department of Psychiatry, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. Email p.de.jonge@med.umcg.nl
Footnotes
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Declaration of interest

None.

Footnotes
References
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Myocardial infarction and generalised anxiety disorder: 10-year follow-up

  • Annelieke M. Roest (a1), Marij Zuidersma (a1) and Peter de Jonge (a2)
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eLetters

Myocardial Infarction and Generalized Anxiety Disorder

MANJEET S. BHATIA, Professor and Head, Psychiatry
10 October 2012

Though with limitations of small sample size;no information on duration of Generalized Anxiety Disorder (GAD) and Depression; no comparison of development of GAD with Depression with other groups (only GAD or Depression), the study has used standardized diagnostic criteria with long term follow up and offers important results which can be a gateway for future research in management of coronary heart disease (CHD).However, there are many important observations which could added to the utility of study i.e. role of life events; type of drugs used in treatmentin GAD and CHD; chronology of GAD, hypertension and CHD; reference for diagnostic criteria of CHD; compliance with treatment of GAD and CHD; comparison with a control group such as Stroke; GAD with degree of decrease in ejection fraction and explanation for more patients with hypertension and hypercholesterolaemia in group without GAD and more diabetic patients in those with GAD.Early assessment after cardiac event would have been better as pattern (acute stress reaction, PTSD, GAD) and severity of psychiatric morbidity tends to change with time.

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Conflict of interest: None declared

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