Anxiety Level and Cardiac Autonomic Modulations in Coronary Artery Disease and Cardiac Syndrome X Patients

Lutfi, Mohamed Faisal

doi:10.1371/journal.pone.0170086

Cited by 5 publications

(4 citation statements)

References 41 publications

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“…Some researchers and cardiologists consider atypical chest pain as subclinical manifestation of CVD when associated with positive stress test 27 . The patients from the NCCP group, took medications prescribed by a cardiologist (betablockers, acetylsalicylic acid), despite the fact that CVD was not confirmed.…”

Section: Discussionmentioning

confidence: 99%

Psychological characteristics in patients with non-cardiac chest pain

et al. 2019

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Background/Aim. Chest pain of no heart origin resembles angina and when none medical reason is found, the patients are referred to psychiatrist for further assessment. The aim of this reserch was to determine psychological characteristics of the patients with non-coronary chest pain (NCCP), difference compared to the coronary patients and the predictive value of those parameters for NCCP. Methods. Fourty consecutively recruited patients without a diagnose of heart disease (NCCP group) were examined and compared to 45 coronary patients (C group). For psychiatric diagnose, the Mini-International Neuropsychiatric Interview (MINI) was used. Psychological symptoms were assessed by the Symptom Checklist-90-Revised (SCL-90R), exposure to life events was scored by the Holms &Rahe Scale and levels of anxiety and depressiveness by the Back Anxiety Inventory and Back Depression Inventory. The statistical analysis was done by using the software package SPPS17. The Student's-t test and χ 2-test were used for estimating more difference between groups while ANOVA determined parameters associated with NCCP. Results. The NCCP patients were younger (33.40 ± 5.43 vs. 48.37 ± 6.43, p < 0.001), more anxious (20.47 ± 11.93 vs. 9.63 ± 3.86, p < 0.001), had more exposure to life events (102.03 ± 52.22 vs. 46.5 ± 55.08, p < 0.001) and were more distressed (41.37 ± 7.70 vs. 29.37 ± 5.67, p < 0.001), while coronary patients were more depressed and hostile. The regression analysis indicated that elevation in anxiety score for 1 point, means 25% of a higher chance [odds ratio (OR) = 1.25; 95% confidence interval (CI): 1.10-1.41] and elevation in the Life events score, means 2% of a higher chance that subject belonged to the NCCP group (OR = 1.02; 95% CI: 1.01-1.03). The younger subjects were more likely to have non-cardiac chest pain (OR = 0.58, 95% CI: 0.42-0.80). Conclusion. The results suggested that the patients with NCCP had none associated psychiatric disorder, but showed higher distress level, more exposure to negative life events and moderate anxiety level. Psychological help could be of a benefit to prevent possible psychiatric issues in young people with non-cardiac chest pain.

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Section: Discussionmentioning

confidence: 99%

Psychological characteristics in patients with non-cardiac chest pain

et al. 2019

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“…CSX patients reported more depression, anxiety, and somatic concerns than patients with confirmed coronary disease [23]. In contrast to Lutfi’s study [24], which demonstrated that the Taylor Manifest anxiety score questionnaire 35 failed to show significant association with CSX, Asbury et al [25] observed that CSX patients showed more life interference and higher HADS anxiety scores than CHD patients, and CSX and CHD patients both had higher depression scores than the healthy controls [24, 25]. Consistent with the literature, in this study, CSX patients had much higher anxiety and depression scores than the healthy controls ( p < 0.001, p = 0.003 respectively).…”

Section: Discussionmentioning

confidence: 99%

Level of Anxiety and Depression in Cardiac Syndrome X

Çekirdekçi

Buğan²

2018

Med Princ Pract

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Objective: Cardiac syndrome X (CSX) is defined as angina-like symptoms, abnormalities on stress testing, and normal epicardial coronary arteries on coronary angiography. The aim of this study was to determine the Hospital Anxiety and Depression scores of patients with CSX and to compare with healthy controls. Materials/Subjects and Methods: Patients undergoing coronary angiography between January 2015 and December 2016 because of clinical indications, including abnormal noninvasive test results were examined. Two hundred and 10 subjects (110 patients with CSX, 100 controls) were enrolled. Demographic characteristics including age, education level, marriage status, and history of stressful life events were recorded. The Turkish version of the Hospital Anxiety and Depression scale was evaluated in the study population. Results: Anxiety, depression, and total scores in the patients with CSX were significantly higher than those in the control group (p < 0.001, p < 0.003, p < 0.001, respectively). Among women, anxiety, depression, total scores, and stressful life events were significantly higher in the CSX group (p = 0.006, p = 0.015, p = 0.001, p < 0.001, respectively). Patients with lower educational status had higher anxiety scores (p = 0.03), stressful life events, and HAD-A > 10 were the only independent predictors of CSX in logistic regression analysis with comparable ORs 2.256 (95% CI 1.057–4.817, p = 0.03) and 2,399 (95% CI 1.248–4.613, p = 0.009) respectively. Conclusion: The results of our research suggest that patients with CSX have a high prevalence of stress and psychiatric disturbances. Interventions targeted toward improving the quality of life and to give psychological support may have the potential benefits especially for women and individuals with lower education.

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“…Conversely, a decreased tolerance for cardiac pain may be the pathophysiological background for NOCAD. In addition, these patients are much more likely to suffer from anxiety and panic disorders, which could be responsible for angina-like symptoms [ 21 , 22 ]. Moreover, the hypersensitivity to right atrial pressure and volume alterations may play a role as well [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Predisposing to Angina in Patients with Non-Obstructive Coronary Arteries: A Retrospective Analysis

Wiśniewski

Dydowicz

Salamaga

et al. 2022

JPM

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No hemodynamically significant atherosclerotic plaques are observed in up to 30% of patients reporting angina and undergoing coronary angiography. To investigate risk factors associated with non-obstructive coronary artery disease (NOCAD), we analyzed the medical records of, consecutively, 136 NOCAD subjects and 128 patients with significant stenosis in at least one coronary artery (the OCAD group). The blood concentrations of the TC (4.40 [3.78–5.63] mmol/L vs. 4.12 [3.42–5.01] mmol/L; p = 0.026), LDL-C (2.32 [1.80–3.50] mmol/L vs. 2.10 [1.50–2.70] mmol/L; p = 0.003), non-HDL-C (2.89 [2.29–4.19] mmol/L vs. 2.66 [2.06–3.39] mmol/L; p = 0.045), as well as the LDL-C/HDL-C ratio (1.75 [1.22–2.60] vs. 1.50 [1.10–1.95]; p = 0.018) were significantly increased in the NOCAD patients compared to the OCAD group due to the lower prevalence and intensity of the statin therapy in the NOCAD individuals (p < 0.001). Moreover, the abovementioned lipid parameters appeared to be valuable predictors of NOCAD, with the LDL-C (OR = 1.44; 95%CI = 1.14–1.82) and LDL-C/HDL-C (OR = 1.51; 95%CI = 1.13–2.02) showing the highest odds ratios. Furthermore, multivariable logistic regression models determined female sex as the independent risk factor for NOCAD (OR = 2.37; 95%CI = 1.33–4.20). Simultaneously, arterial hypertension substantially lowered the probability of NOCAD (OR = 0.21; 95%CI = 0.10–0.43). To conclude, female sex, the absence of arterial hypertension, as well as increased TC, LDL-C, non-HDL, and LDL-C/HDL-C ratio are risk factors for NOCAD in patients reporting angina, potentially as a result of poor hypercholesterolemia management.

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Anxiety Level and Cardiac Autonomic Modulations in Coronary Artery Disease and Cardiac Syndrome X Patients

Cited by 5 publications

References 41 publications

Psychological characteristics in patients with non-cardiac chest pain

Psychological characteristics in patients with non-cardiac chest pain

Level of Anxiety and Depression in Cardiac Syndrome X

Risk Factors Predisposing to Angina in Patients with Non-Obstructive Coronary Arteries: A Retrospective Analysis

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