Anxiety disorders increase risk for incident myocardial infarction in depressed and nondepressed Veterans Administration patients

被引:106
作者
Scherrer, Jeffrey F. [1 ,2 ]
Chrusciel, Timothy [1 ,3 ]
Zeringue, Angelique [1 ,3 ]
Garfield, Lauren D. [1 ,5 ]
Hauptman, Paul J. [1 ,5 ]
Lustman, Patrick J. [1 ,4 ]
Freedland, Kenneth E. [4 ]
Carney, Robert M. [4 ]
Bucholz, Kathleen K. [1 ,2 ]
Owen, Richard [6 ,7 ,8 ]
True, William R. [1 ,9 ]
机构
[1] St Louis Vet Affairs Med Ctr, Res Serv, Clin Res & Epidemiol Workgrp, St Louis, MO 63103 USA
[2] Washington Univ, Sch Med, Midwest Alcoholism Res Ctr, St Louis, MO USA
[3] Washington Univ, Sch Med, Dept Internal Med, St Louis, MO USA
[4] Washington Univ, Sch Med, Dept Psychiat, St Louis, MO USA
[5] St Louis Univ, Sch Med, St Louis, MO USA
[6] Cent Arkansas Vet Healthcare Syst, HSR&D Ctr Mental Healthcare & Outcomes Res, Little Rock, AR USA
[7] Univ Arkansas Med Sci, Coll Publ Hlth, Dept Epidemiol, Little Rock, AR 72205 USA
[8] Univ Arkansas Med Sci, Coll Med, Dept Psychiat, Little Rock, AR 72205 USA
[9] Washington Univ, George Warren Brown Sch Social Work, St Louis, MO 63130 USA
关键词
CORONARY-HEART-DISEASE; PHOBIC ANXIETY; CARDIOVASCULAR EVENTS; ARTERY-DISEASE; MORTALITY; MEN; COMORBIDITY; PREVALENCE; AFFAIRS; WOMEN;
D O I
10.1016/j.ahj.2010.02.033
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Depression is a risk factor for incident myocardial infarction (MI), but little is known about the independent or additive risk from anxiety disorders. Methods In a 7-year retrospective cohort design, we identified a cohort free of cardiovascular disease in fiscal years 1999 and 2000 that contained 96,612 patients between 25 and 80 years of age who had an International Classification of Diseases, Ninth Revision, Clinical Modification code indicating a diagnosis of depression in 2000 (baseline) and 259,387 patients without depression. Cox proportional hazards models stratified by depression were computed to test for a main effect of anxiety disorder unspecified, generalized anxiety disorder, panic disorder, social phobia, obsessive-compulsive disorder, and posttraumatic stress disorder (PTSD) on risk of incident MI. The models were adjusted for multiple MI risk factors and sociodemographics. Results Depressed as compared to nondepressed Veterans Administration patients were at increased risk for incident MI (HR 1.39; 95% CI 1.34-1.45). In nondepressed patients those with anxiety disorder unspecified (HR 1.34; 95% CI 1.21-1.47), panic disorder (HR 1.43; 95% CI 1.11-1.83), and PTSD (HR 1.25; 95% CI 1.16-1.36) were at increased risk for incident MI. The independent risk associated with anxiety disorders was reduced in patients comorbid for depression. Conclusions In Veterans Administration patients free of heart disease in 1999 and 2000, those with depression, anxiety disorder unspecified, panic disorder, and PTSD were at increased risk of incident MI. Anxiety disorders are independent risk factors for MI. Depression partially accounts for the effect of anxiety disorders on risk of MI in patients with both conditions. (Am Heart J 2010; 159: 772-9.)
引用
收藏
页码:772 / 779
页数:8
相关论文
共 34 条
  • [31] Are claims data accurate enough to identify patients for performance measures or quality improvement? The case of diabetes, heart disease, and depression
    Solberg, Leif I.
    Engebretson, Karen I.
    Sperl-Hillen, JoAnn M.
    Hroscikoski, Mary C.
    O'Connor, Patrick J.
    [J]. AMERICAN JOURNAL OF MEDICAL QUALITY, 2006, 21 (04) : 238 - 245
  • [32] Thakore JoginH., 2001, Physical Consequences of Depression
  • [33] Change in depression as a precursor of cardiovascular events
    WassertheilSmoller, S
    Applegate, WB
    Berge, K
    Chang, CJ
    Davis, BR
    Grimm, R
    Kostis, J
    Pressel, S
    Schron, E
    [J]. ARCHIVES OF INTERNAL MEDICINE, 1996, 156 (05) : 553 - 561
  • [34] Wright SM, 1997, HEALTH SERV RES, V31, P739