Impact of anxiety and perceived control on in-hospital complications after acute myocardial infarction

Moser, DK; Riegel, B; McKinley, S; Doering, LV; An, K; Sheahan, S

Impact of anxiety and perceived control on in-hospital complications after acute myocardial infarction

Moser, DK Riegel, B McKinley, S Doering, LV An, K Sheahan, S

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Publication Type:: Journal Article
Citation:: Psychosomatic Medicine, 2007, 69 (1), pp. 10 - 16
Issue Date:: 2007-01-01

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Field	Value	Language
dc.contributor.author	Moser, DK	en_US
dc.contributor.author	Riegel, B	en_US
dc.contributor.author	McKinley, S	en_US
dc.contributor.author	Doering, LV	en_US
dc.contributor.author	An, K	en_US
dc.contributor.author	Sheahan, S	en_US
dc.date.issued	2007-01-01	en_US
dc.identifier.citation	Psychosomatic Medicine, 2007, 69 (1), pp. 10 - 16	en_US
dc.identifier.issn	0033-3174	en_US
dc.identifier.uri	http://hdl.handle.net/10453/4504
dc.description.abstract	OBJECTIVES: We tested the hypothesis that perception of control moderates any relationship between anxiety and in-hospital complications (i.e., recurrent ischemia, reinfarction, sustained ventricular tachycardia or fibrillation, and cardiac death) in patients with acute myocardial infarction (AMI). BACKGROUND: Anxiety is common among patients with AMI, but whether it is associated with poorer outcomes is controversial. Conflicting findings about the relationship of anxiety with cardiac morbidity and mortality may result from failure to consider the moderating effect of perceived control. METHODS: This was a prospective examination of the association among anxiety, perceived control, and subsequent in-hospital complications among patients (N = 536) hospitalized for AMI. RESULTS: Patients' mean anxiety level was double that of the published mean norm. Patients with higher levels of perceived control had substantially lower anxiety (p = .001). A total of 145 (27%) patients experienced one or more in-hospital complications. Patients with higher levels of anxiety had significantly more episodes of ventricular tachycardia, ventricular fibrillation, and reinfarction and ischemia (p < .01 for all). In a multivariate hierarchical logistic regression model, left ventricular ejection fraction, history of myocardial infarction, anxiety score, and the interaction of anxiety and perceived control were significant predictors of complications. CONCLUSION: Anxiety during the in-hospital phase of AMI is associated with increased risk for in-hospital arrhythmic and ischemic complications that is independent of traditional sociodemographic and clinical risk factors. This relationship is moderated by level of perceived control such that the combination of high anxiety and low perceived control is associated with the highest risk of complications. Copyright © 2007 by American Psychosomatic Society.	en_US
dc.relation.ispartof	Psychosomatic Medicine	en_US
dc.relation.isbasedon	10.1097/01.psy.0000245868.43447.d8	en_US
dc.subject.classification	Psychiatry	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Myocardial Ischemia	en_US
dc.subject.mesh	Myocardial Infarction	en_US
dc.subject.mesh	Death	en_US
dc.subject.mesh	Recurrence	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Anxiety	en_US
dc.subject.mesh	Internal-External Control	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Inpatients	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Arrhythmias, Cardiac	en_US
dc.title	Impact of anxiety and perceived control on in-hospital complications after acute myocardial infarction	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	69	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	69	en_US

Abstract:

OBJECTIVES: We tested the hypothesis that perception of control moderates any relationship between anxiety and in-hospital complications (i.e., recurrent ischemia, reinfarction, sustained ventricular tachycardia or fibrillation, and cardiac death) in patients with acute myocardial infarction (AMI). BACKGROUND: Anxiety is common among patients with AMI, but whether it is associated with poorer outcomes is controversial. Conflicting findings about the relationship of anxiety with cardiac morbidity and mortality may result from failure to consider the moderating effect of perceived control. METHODS: This was a prospective examination of the association among anxiety, perceived control, and subsequent in-hospital complications among patients (N = 536) hospitalized for AMI. RESULTS: Patients' mean anxiety level was double that of the published mean norm. Patients with higher levels of perceived control had substantially lower anxiety (p = .001). A total of 145 (27%) patients experienced one or more in-hospital complications. Patients with higher levels of anxiety had significantly more episodes of ventricular tachycardia, ventricular fibrillation, and reinfarction and ischemia (p < .01 for all). In a multivariate hierarchical logistic regression model, left ventricular ejection fraction, history of myocardial infarction, anxiety score, and the interaction of anxiety and perceived control were significant predictors of complications. CONCLUSION: Anxiety during the in-hospital phase of AMI is associated with increased risk for in-hospital arrhythmic and ischemic complications that is independent of traditional sociodemographic and clinical risk factors. This relationship is moderated by level of perceived control such that the combination of high anxiety and low perceived control is associated with the highest risk of complications. Copyright © 2007 by American Psychosomatic Society.

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