FREQUENCY OF ANXIETY AND PSYCHOSOCIAL STRESSFUL EVENTS IN PATIENTS WITH ACUTE MYOCARDIAL INFRACTION
Abstract
Background: The impact of psychological factors in acute coronary events is only now emerging. Agrowing body of evidence attests to the influence of emotional and stress-related psychosocialfactors in the aetiology of Coronary Artery Disease (CAD) and morbidity and mortality amongindividuals with coronary heart disease. The objectives were to look for the frequency of anxiety andpsychosocial stressful events in patients with acute myocardial infarction. Methods: Two hundredconsecutive patients of Acute Myocardial Infarction (AMI) without complications who presented tothe Coronary Care Unit of Cardiology Department, Lady Reading Hospital Peshawar, and 200healthy controls among relatives of patients were assessed on Holmes Rahe Social scale (HRS) andHospital Anxiety and Depression Scale (HADS) scale for the presence of anxiety and stressful lifeevents in period preceding AMI. Results: Sixty-three percent of the patients were male in bothgroups. Mean age of patients was 59 years while that of controls was 52 years. For scores of anxietyon HADS, 34% of the controls had normal score compared to of the 19% AMI group (p<0.001),while 57% of the AMI patients had abnormal score compared to 39% of the control group (p<0.001).The number events reported on HRS scale in patients with AMI were significantly more (4.2±2)compared to the number of events (2.7±1.6) in the control group with (p<0.001). Scores for thenumber of events on HRS scale were significantly less (98±64) in controls compared to (158±5.8) ingroup with AMI (p<0.001). Anxiety was diagnosed in 70% of the female patients compared to 50%of the male patients. Conclusion: Significant number of patients with acute myocardial infarctionwhen assessed on standard scales had anxiety and stressful life events in the weeks preceding theevent. These were more common in female than male patients.Keywords: Anxiety, Stress, Myocardial Infarction, Coronary, HADSReferences
Pignalberi C, Ricci R, Santini M. Psychological stress and
sudden death. Ital Heart J 2002;3:1011–21.
Kinjo K, Sato H, Sato H, Shiotani I, Kurotobi T, Ohnishi Y,
et al. Variation during the week in the incidence of acute
myocardial infarction: increased risk for Japanese women on
Saturdays. Heart 2003;89:398–403.
Dimsdale JE. Psychological Stress and Cardiovascular
Disease. J Am Coll Cardiol 2008;51:1237–46.
ENRICHD Investigators. Enhancing recovery in coronary
heart disease (ENRICHD) study intervention: rationale and
design. Psychosom Med 2001;63:747–55.
Dimsdale JE. Psychological Stress and Cardiovascular
Disease. J Am Coll Cardiol 2008;51:1237–46.
Hemingway H, Kuper H, Marmot M. Psychosocial factors in
the primary and secondary prevention of coronary heart
disease: an updated systematic review of prospective cohort
studies. In: Yousaf S, Cairns JA, Camm AJ, Fallen EL, Gersh
BJ, eds. Evidence-Based Cardiology, 2nd ed. London: BMJ
Books;2003.p. 181–218.
Smith TW, Ruiz JM. Psychosocial influences on the
development and course of coronary heart disease: current
status and implications for research and practice. J Consult
Clin Psychol 2002;70:548–68.
Rozanski A, Blumenthal JA, Davidson KW, Saab PG,
Kubzansky L. The epidemiology, pathophysiology, and
management of psychosocial risk factors in cardiac practice:
the emerging field of behavioral cardiology. J Am Coll
Cardiol 2005;45:637–51.
Jakobsen AH, Leslie Foldager L, Parker G, Munk-Jørgensen
P. Quantifying links between acute myocardial infarction and
depression, anxiety and schizophrenia using case register
databases. J Affective Disord 2008;109:177–81.
Akhtar MS, Khan MA, Malik SB. Psychosocial factors
associated with symptoms of depression and anxiety
following Acute Myocardial Infarction. Pak J Med Sci
;24(2):192–7.
Moser DK, Dracup K. Is anxiety early after myocardial
infarction associated with subsequent ischemic and
arrhythmic events? Psychosom Med 1996;58:395–401.
Chockalingam A, Venkatesan S, Dorairajan S, Moorthy C,
Chockalingam V, Subramaniam T. Estimation of Subjective
Stress in Acute Myocardial Infarction. J Postgrad Med
;49:207–10.
Zigmond AS, Snaith RP. The Hospital Anxiety and
Depression Scale. Acta Psychiatrica Scandinavica
;67:361–70.
Holmes TH, Rahe RH. The Social Readjustment Rating
Scale. J Psychosom Res 1967;11:213–8.
Mayou RA, Gill D, Thomson DR, Day A, Hicks N, Volmink
J, Neil A. Depression and anxiety as predictors of outcome
after myocardial infarction. Psychosom Med 2000;62:212–9.
Mcculloch J. Hospital anxiety and depression in myocardial
infarction patients. Br J Cardiol 2007;14:106–8.
Rahe RH, Mahan JL, Arthur RJ. Prediction of near-future
health change from subjects’ preceding life changes. J
Psychosom Res 1970;14:401–6.
Dickens CM, McGowan L, Percival C, Tomenson B, Cotter
L, Heagerty A, et al. Lack of a close confidant, but not
depression, predict further cardiac events after myocardial
infarction. Heart 2004;90:518–22.
Chockalingam A, Vankatesan S, Dorairajan S, Chockalingam
V, Subramanain T. Esimation of subjective stress in acute
myocardial infarction. J Postgrad Med 2003;49:207–10.
Yusaf S, Hawken S, Oupuu S, Dans T, Avezum A, Lanas F,
et al. Effect of potentially modifiable risk factors associated
with myocardial infarction in 52 countries (the
INTERHEART Study): case control study. Lancet
;364:937–52.
Nishtar S. Coronary artery disease burden in Pakistan —A
review. J Pak Inst Med Sci 2001;8(12):592–4.
Khan MA, Mahmood ul Hassan, Mohammad Hafizullah.
Coronary Artery Disease, Is it more frequently effecting
younger age group and women? Pak Heart J 2006;39:17–21.
Wattoo FH, Memon MS, Memon AN, Wattoo MHS, Tirmizi
SA, Iqbal J. Effect of stress on serum lipid levels in lady
health visitors and housewives. Rawal Med J 2007;32(1):4–4.
Marrugat J, Garcia M, Elosua R, Aldasoro E, Omro MJ,
Zurriaga O, et al. Short-term (28 days) prognosis between
genders according to the type of coronary event (Q-wave
versus non-Q-wave acute myocardial infarction versus
unstable Angina pectoris). Am J Cardiol 2004;94:1161–5.
Guriro A. Suicides rising in Karachi. Daily Times. Monday,
August 2008 available at http/www.dailytimes.com.pk/08.
Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M,
Almahmeed WA et al. Association of psychosocial risk
factors with risk of acute myocardial infarction in 11119
cases and 13648 controls from 52 countries (the
INTERHAERT study): case control study. Lancet
;364:953–62.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.