title: Panic disorder and incident coronary heart disease: a systematic review and meta-analysis protocol.
abstract: BACKGROUND
  The clinical presentation of panic disorder and panic attack overlaps many symptoms typically experienced in coronary heart disease (CHD). Etiological links between panic disorder and CHD are controversial and remain largely tenuous. This systematic review aims to pool together data regarding panic disorder with respect to incident CHD or myocardial infarction.
  
  
  METHODS
  Electronic databases (MEDLINE, EMBASE, PsycINFO and SCOPUS) will be searched using a search strategy exploding the topics for CHD and panic disorder. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows:
  
  
  METHODS
  persons without CHD who meet criteria for panic disorder, panic attack, anxiety neurosis or elevated panic disorder symptoms; Comparison: persons without CHD who do not meet criteria for panic disorder, panic attack, anxiety neurosis or elevated panic disorder symptoms;
  
  
  RESULTS
  verified fatal and non-fatal CHD at follow-up; including coronary revascularization procedure, coronary artery disease, and myocardial infarction. Studies adopting self-report CHD will be ineligible. Screening will be undertaken by two independent reviewers with disagreements resolved through discussion. Data extraction will include original data specified as hazard ratios, risk ratios, and original cell data if available. Risk of bias assessment will be undertaken by two independent reviewers. Meta-analytic methods will be used to synthesize the data collected relating to the CHD outcomes with Cochrane Review Manager 5.3.
  
  
  CONCLUSIONS
  This systematic review aims to clarify whether panic disorder is associated with elevated risk for subsequent CHD. An evaluation of the etiological links between panic disorder with incident CHD might inform evidence-based clinical practice and policy concerning triaging chest pain patients, diagnostic assessment, and psychiatric intervention with panic disorder patients.
  
  
  BACKGROUND
  PROSPERO CRD42014014891 .
authors: Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, Freiburg, 79085, Germany. phillip.tully@adelaide.edu.au.|Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, 254 North Terrace, Adelaide, Australia. phillip.tully@adelaide.edu.au.
authors: Phillip J
authors: PJ
authors: Tully
authors: Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, 254 North Terrace, Adelaide, Australia. gary.wittert@adelaide.edu.au.
authors: Gary A
authors: GA
authors: Wittert
authors: Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, 254 North Terrace, Adelaide, Australia. deborah.turnbull@adelaide.edu.au.
authors: Deborah A
authors: DA
authors: Turnbull
authors: Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, 28 Woodville Road, Adelaide, Australia. john.beltrame@adelaide.edu.au.
authors: John F
authors: JF
authors: Beltrame
authors: Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth Hospital, University of Adelaide, 28 Woodville Road, Adelaide, Australia. john.horowitz@adelaide.edu.au.
authors: John D
authors: JD
authors: Horowitz
authors: Clinic of Psychiatry and Psychotherapy II, University of Ulm, Helmholtzstr, Gunzburg, Germany. suzie.cosh@adelaide.edu.au.
authors: Suzanne
authors: S
authors: Cosh
authors: Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstr. 41, Freiburg, 79085, Germany. harald.baumeister@psychologie.uni-freiburg.de.
authors: Harald
authors: H
authors: Baumeister
mesh_terms: D002985:Clinical Protocols; D003324:Coronary Artery Disease / Q000209:etiology*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology*; D010200:Panic; D016584:Panic Disorder / Q000150:complications*; D012107:Research Design; D000078202:Systematic Reviews as Topic; D015201:Meta-Analysis as Topic