Abstract 9759: Race Moderates the Relationship Between Anxiety and Quality of Life in Implantable Cardioverter Defibrillator Recipients

Abstract

Introduction: The implantable cardioverter defibrillator (ICD) has significantly decreased mortality for populations at high risk for sudden cardiac arrest. Despite its effectiveness, this treatment modality comes with a high potential for psychological distress. The prevalence rate of anxiety in ICD recipients is 50%, with the highest levels reported in Black ICD recipients, yet little is known about the role of race in the relationship between anxiety and quality of life (QOL). Understanding racial disparities in the experience of ICD recipients has been limited due to low numbers of Black participants in research studies. This is reflective of the clinical reality that fewer Black patients for whom an ICD is appropriate are offered or accept the treatment. Methods: In this cross-sectional study we used the Hayes SPSS Process macro for moderation analysis (model 1) with 5000 bootstrap samples to determine whether race moderated the relationship between anxiety (Brief Symptom Inventory) and QOL (EURO-QOL-5D3L). Results: Using data from 136 participants (18% Black, 27% women with mean age 63 + 12 and education 14 + 3), we entered anxiety, race, and the interaction term into a simultaneous regression model while controlling for gender, age, education, depression, history of shock, and ICD knowledge. The interaction between anxiety and race was significant (B = -.1330, SE = .1339, p < .015), suggesting that the effect of anxiety on QOL differed between Black and White ICD recipients. Together, the variables accounted for approximately 33% of the variance in QOL (R 2 = .33, F (1,126) = 6.08, p < .001). Simple slope tests revealed a significant negative association between anxiety and QOL for Black ICD recipients (B = -.3712, SE = .05, p = .005) but not for White ICD recipients (B = -.0412, SE = .0478, p = .390). Conclusion: Assessment, recognition, and referral for treatment of anxiety in ICD recipients, particularly Black ICD recipients, may improve QOL for this population.