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Anxiety Associated with Poor Heart Disease Outcome

Authors find higher risk in those with highest stress level versus lowest

TUESDAY, May 15 (HealthDay News) -- Anxiety is associated with an increased risk of myocardial infarction or death in patients who have been diagnosed with coronary artery disease, according to a report in the May 22 issue of the Journal of the American College of Cardiology.

Charles M. Blatt, M.D., of Lown Cardiovascular Center in Brookline, Mass., and colleagues conducted a prospective cohort study of 516 patients with coronary artery disease. They used annual questionnaires to determine the effect of anxiety on a combined outcome of non-fatal myocardial infarction and all-cause mortality.

The study identified 44 non-fatal myocardial infarctions and 19 deaths during an average follow-up of 3.4 years and found that anxiety was significantly associated with the primary outcome. After dividing the cohort into thirds based on anxiety level, the investigators found that patients in the highest tertile of anxiety had a 1.97-fold higher risk for myocardial infarction or death compared with those in the lowest tertile. Multivariate adjustments reduced the risk to a lower but still significant 1.06-fold.

"Repeated measures of anxiety predicted the composite outcome of non-fatal myocardial infarction or death in patients with stable coronary artery disease," the authors write. "Baseline anxiety scores failed to predict these outcomes, suggesting that assessing anxiety regularly over the long term is necessary."

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