Open AccessThe association between anxiety disorders and in‐hospital outcomes in patients with myocardial infarction
Author(s) -
Li Pengyang,
Lu Xiaojia,
Kranis Mark,
Wu Fangcheng,
Teng Catherine,
Cai Peng,
Hashmath Zeba,
Wang Bin
Publication year - 2020
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23358
Subject(s) - medicine , cardiogenic shock , myocardial infarction , anxiety , propensity score matching , cardiology , incidence (geometry) , retrospective cohort study , cohort , psychiatry , physics , optics
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.