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Multicenter Study
. 2020 Jun;43(6):622-629.
doi: 10.1002/clc.23358. Epub 2020 Mar 18.

The association between anxiety disorders and in-hospital outcomes in patients with myocardial infarction

Pengyang Li  1 , Xiaojia Lu  2 , Mark Kranis  3 , Fangcheng Wu  4 , Catherine Teng  5 , Peng Cai  6 , Zeba Hashmath  1 , Bin Wang  2
Affiliations
Multicenter Study

The association between anxiety disorders and in-hospital outcomes in patients with myocardial infarction

Pengyang Li et al. Clin Cardiol. 2020 Jun.

Abstract

Background: Anxiety disorders are prevalent in patients with myocardial infarction (MI), but the effects of anxiety disorders on in-hospital outcomes within MI patients have not been well studied.

Hypothesis: To examine the effects of concurrent anxiety disorders on in-hospital outcomes in MI patients.

Methods: We conducted a retrospective cohort study in patients with a principal diagnosis of MI with and without anxiety disorders in the National Inpatient Sample 2016. A total of 129 305 primary hospitalizations for acute MI, 35 237 with ST-segment elevation myocardial infarction (STEMI), and 94 068 with non-ST elevation myocardial infarction (NSTEMI) were identified. Of these, 13 112 (10.1%) had anxiety (7.9% in STEMI and 11.0% in NSTEMI). We compared outcomes of anxiety and nonanxiety groups after propensity score matching for the patient and hospital demographics and relevant comorbidities.

Results: After propensity score matching, the anxiety group had a lower incidence of in-hospital mortality (3.0% vs 4.4%, P < .001), cardiac arrest (2.1% vs 2.8%, P < .001), cardiogenic shock (4.9% vs 5.6%, P = .007), and ventricular arrhythmia (6.7% vs 7.9%, P < .001) than the nonanxiety group. In the NSTEMI subgroup, the anxiety group had significantly lower rates of in-hospital mortality (2.3% vs 3.5%, P < .001), cardiac arrest (1.1% vs 1.5%, P = .008), and cardiogenic shock (2.8% vs 3.5%, P = .008). In the STEMI subgroup, we found no differences in in-hospital outcomes (all P > .05) between the matched groups.

Conclusion: Although we found that anxiety was associated with better in-hospital outcomes, subgroup analysis revealed that this only applied to patients admitted for NSTEMI instead of STEMI.

Keywords: anxiety disorders; in-hospital outcomes; myocardial infarction.

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Conflict of interest statement

The authors declare no potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the selection process for the final patient sample used in this study. Inclusion criteria were applied to the National Inpatient Sample 2016 database. All eligible patients were matched 1:1 based on propensity scoring to generate the anxiety vs nonanxiety comparison cohorts. ICD‐10‐CM code, Tenth Revision, Clinical Modification Code. MI, myocardial infarction; NSTEMI, non‐ST elevation myocardial infarction; STEMI, ST‐segment elevation myocardial infarction
See this image and copyright information in PMC

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