title: Anxiety levels of patients undergoing coronary procedures in the catheterization laboratory.
abstract: BACKGROUND
  High 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.
  
  
  METHODS
  Patients 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.
  
  
  RESULTS
  In 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.
  
  
  CONCLUSIONS
  In 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.
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Ronak
authors.initials: R
authors.lastname: Delewi
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Wieneke
authors.initials: W
authors.lastname: Vlastra
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Rohling
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Tineke C
authors.initials: TC
authors.lastname: Wagenaar
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Max
authors.initials: M
authors.lastname: Zwemstra
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Meesterman
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Marije M
authors.initials: MM
authors.lastname: Vis
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Joanna J
authors.initials: JJ
authors.lastname: Wykrzykowska
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Karel T
authors.initials: KT
authors.lastname: Koch
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Baan
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
authors.affiliation: Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Mirjam A G
authors.initials: MA
authors.lastname: Sprangers
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: j.p.henriques@amc.uva.nl.
authors.forename: José P S
authors.initials: JP
authors.lastname: Henriques
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000175:diagnosis* / Q000453:epidemiology; D006328:Cardiac Catheterization / Q000379:methods / Q000523:psychology*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods / Q000523:psychology*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D062645:Percutaneous Coronary Intervention / Q000379:methods / Q000523:psychology*; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors
keywords: Anxiety; Coronary angiography; Percutaneous coronary intervention