Myocardial Infarction and Generalised Anxiety Disorder: 10-year Follow-up

Background: Few studies have addressed the relationship between generalised anxiety disorder and cardiovascular prognosis using a diagnostic interview.

Aims: To assess the association between generalised anxiety disorder and adverse outcomes in patients with myocardial infarction.

Method: Patients with acute myocardial infarction (n = 438) were recruited between 1997 and 2000 and were followed up until 2007. Current generalised anxiety disorder and post-myocardial infarction depression were assessed with the Composite International Diagnostic Interview. The end-point consisted of all-cause mortality and cardiovascular-related readmissions.

Results: During the follow-up period, 198 patients had an adverse event. Generalised anxiety disorder was associated with an increased rate of adverse events after adjustment for age and gender (hazard ratio: 1.94; 95% confidence interval: 1.14-3.30; P = 0.01). Additional adjustment for measures of cardiac disease severity and depression did not change the results.

Conclusions: Generalised anxiety disorder was associated with an almost twofold increased risk of adverse outcomes independent demographic and clinical variables and depression.