Anxiety after Acute Myocardial Infarction and In-Hospital Complications

An, Kyungeh

Abstract

PURPOSE OF THE STUDY: A retrospective and descriptive survey was conducted to investigate the level of anxiety that patients experience in early stage of AMI and to examine whether anxiety independently predict inhospital complications. SIGNIFICANCE OF THE STUDY: AMI is a major cause of death and disability. Anxiety may contribute to developing complications and mortality. However, the association between anxiety and complications has not been examined.
RESULTS
Data were analyzed for 424 AMI patients enrolled for MICA (Myocardial Infarotion Complication and Anxiety) project. The mean score of the state anxiety inventory (SAI) measured within 72 hours after admission for the whole sample was 39.14 (+/-12.77) and ranged from 18 to 80. Overall, 161 patients (38.0%) experienced at least one episode of in-hospital complication (i.e. VT, VF, reinfarction, recurrent ischemia or cardiac death). Incidence of in-hospital complications was higher in the high anxiety group than in the low anxiety group (45.4% vs. 31.2%). There were significant differences in the incidence of recurrent ischemia between groups with low level of anxiety and high level of anxiety (27.5% vs. 18.9%). According to the Ward criterion from the logistic regression, anxiety reliably predicted the occurrence of in-hospital complications. Anxiety (odds ratio = 1.75, 95% CI 1.01-3.01, p= 0.04) significantly contributed to the model. Patients who were in the high anxiety group were 1.8 times more likely to have in-hospital complications than those who were in the low anxiety group.
CONCLUSION
AND SUGGESTION: This finding confirms that patients experience significant level of anxiety early after AMI, and this anxiety, after controlling other risk factors for the complications, is a reliable predictor of in-hospital complications.