Abstract
BackgroundHigh levels of anxiety are associated with worse outcomes in coronary artery disease patients. Little is known about anxiety levels in patients undergoing coronary procedures. Our objective is to examine the levels of anxiety in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) during the different phases of hospital stay and to evaluate which patient characteristics are associated with increased anxiety. MethodsPatients undergoing CAG or PCI between April 2009 and April 2010 were included in this prospective cohort study. Anxiety levels were measured using the self reported Visual Analogue Scale (VAS) of Anxiety, ranging from 0 to 100. VAS anxiety scores were obtained at hospital intake, pre- and post-procedure, and at hospital discharge.Multivariate linear regression analyses were performed to assess correlations between baseline characteristics and anxiety levels at the different time points. ResultsIn total 2604 patients were included, with 70.4% male participants with a mean age of 65±12years. VAS anxiety scores were highest pre-procedure (44.2±27.0mm). Female patients reported a significantly higher pre procedure VAS anxiety score (50.4±26.5) compared to males (41.5±26.8, p=0.02). Other factors associated with higher levels of anxiety at different time points were age<65years, low level of education and an acute primary PCI. ConclusionIn the largest cohort to date, we examined anxiety among patients undergoing PCI or CAG was highest immediately around the procedure, particularly in patients aged <65years, of female gender, undergoing primary PCI, or with a lower level of education. Better pre-procedural information or pharmacological strategies may reduce anxiety in these patients.
Highlights
High levels of anxiety are associated with worse outcomes in coronary artery disease patients [1,2]
High levels of anxiety are associated with lowered immune response and alterations of cardiovascular function like impaired heart rate variety, endothelial dysfunction and vascular inflammation, which might result in worse clinical outcomes
Patient characteristics associated with increased pre- and post-procedural anxiety levels during coronary angiography (CAG) or percutaneous coronary intervention (PCI) have not been studied in a large clinical cohort
Summary
High levels of anxiety are associated with worse outcomes in coronary artery disease patients [1,2]. Patient characteristics associated with increased pre- and post-procedural anxiety levels during CAG or PCI have not been studied in a large clinical cohort. Identification of such characteristics could aid health care providers in identifying the patients who are at highest risk for anxiety. Our objective is to examine the levels of anxiety in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) during the different phases of hospital stay and to evaluate which patient characteristics are associated with increased anxiety. Conclusion: In the largest cohort to date, we examined anxiety among patients undergoing PCI or CAG was highest immediately around the procedure, in patients aged b 65 years, of female gender, undergoing primary PCI, or with a lower level of education. Better pre-procedural information or pharmacological strategies may reduce anxiety in these patients
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