One-year follow up of cardiac anxiety after a myocardial infarction: a latent class analysis.
BACKGROUND
Longitudinal elevated depressive symptom scores are associated with a less favorable cardiac outcome. Although anxiety has received less attention, meta-analysis suggests that high baseline levels of general anxiety might worsen cardiac outcome. The objective of this study was to explore the longitudinal course of cardiac anxiety after a myocardial infarction (MI).


METHODS
The Cardiac Anxiety Questionnaire (CAQ) was administered to 194 patients hospitalized for MI after admission, and one, three, six and twelve months after discharge. Latent class growth analysis (LCGA) was performed to identify groups based on cardiac anxiety course. Between group differences were checked on relevant socio-demographic, cardiac and psychiatric variables.


RESULTS
LCGA identified three groups with stable CAQ levels over time, indicative of high (7.7%), intermediate (45.4%) and low (30.4%) levels of cardiac anxiety, respectively. A fourth group (16.5%) reported high levels of cardiac anxiety that decreased over time. Between group differences were of particular interest for the two subgroups that started high in cardiac anxiety, since these may differentiate patients with spontaneous remission from those who might be in need of treatment. Patients in whom cardiac anxiety persisted were less often employed, had more diabetes mellitus, a history of acute coronary syndrome, depressive symptoms, anxiety and avoidance at baseline and a lower quality of life at follow-up.


CONCLUSIONS
This first study addressing cardiac anxiety after an MI identified four trajectories. Future studies should focus on cardiac outcome and treatment strategies for cardiac anxiety in the subgroup with persistent high anxiety levels.
Radboud University Nijmegen Medical Centre, Department of Psychiatry, Nijmegen, The Netherlands. M.H.C.vanBeek@psy.umcn.nl
M H C T
MH
van Beek
M
M
Mingels
R C Oude
RC
Voshaar
A J L M
AJ
van Balkom
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M
Lappenschaar
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Pop
A E M
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Speckens
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012008:Recurrence; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires