Does panic disorder increase the risk of cardiovascular diseases in diabetics?: A nationwide population-based study

Background: Several studies have suggested a link between panic disorder (PD) and cardiovascular disease (CVD). However, the extent to which PD confers risk for CVD is still unclear, particularly in diabetics, a group showing high risk for CVD.Methods: A nationwide population-based cohort of 1,624,718 patients with type 2 diabetes were selected from the National Health Screening Program database covering the years 2009 to 2012. The subjects were divided into two groups: those without panic disorder (non-PD group, n = 1,618,263) and those with newly diagnosed PD (PD-group, n = 6455). Follow-up of subjects for up to 10 years was conducted for evaluation of the incidences of myocardial infarction (MI), stroke, and death.Results: After adjusting for the baseline covariates and diabetes mellitus (DM)-related variables, no difference in the future risk of MI and stroke was observed between the non-PD group and the PD group. Compared with the non-PD group, the PD group showed an increase in the future risk of death. [adjusted hazard ratio (aHR) =1.120, 95 % confidence interval (CI): 1.039-1.206]. In contrast to the population aged <40 and > 65 years, in the age group of 40-64 years a significantly higher risk of stroke was observed in the PD group compared with the nonPD group (aHR = 1.352, 95%CI: 1.136-1.610). Limitation: The diagnoses were based on the diagnostic codes of the claim data.Conclusion: The current findings suggested that PD might not contribute to the risk of future MI and stroke in diabetics who have already been at risk of various cardiovascular complications.