Anxiety and Depression as Predictors of Acute Myocardia Infarction in Patients with Pre-Existing Coronary Heart Disease | Insight Medical Publishing

Background: Cardiovascular disease is the number one cause of death worldwide. Among all cardiovascular diseases, coronary heart disease is the most common manifestation. It has been hypothesized that anxiety and depression increased the incidence of coronary heart disease in healthy individuals and the acute myocardial infarction in patients with pre-existing coronary heart disease. Therefore, the purpose of this study was to investigate the effect of anxiety and depression on the development of acute myocardial infarction in patients with pre-existing coronary heart disease. Methods and findings: This was a prospective study with patients seeking treatment for coronary heart disease. Anxiety and depression were measured before the occurrence of acute myocardial infarction in 1000 patients with pre-existing coronary heart disease. Patients were followed for two years or until they developed an acute myocardial infarction. In a multiple logistic regression, anxiety and depression scores were independent predictors of the occurrence of acute myocardial infarction (OR=1.55, 95% CI: 1.15-2.10, P=0.005) and (OR 1.77, 95% CI: 1.21- 2.34, P=0.02), respectively. Conclusion: Anxiety and depression predicted acute myocardial infarction in patients with pre-existing coronary heart disease. Inclusion of assessment and treatment of anxiety and depression in the protocols for those patients is as important as the traditional risk factors.