Coronary Artery Spasm as Related to Anxiety and Depression: A Nationwide Population-Based Study

Hung, Ming-Yow; Mao, Chun-Tai; Hung, Ming‐Jui; Wang, Jiunn-Kae; Lee, Hsin Chien; Yeh, Chi‐Tai; Hu, Patrick; Chen, Tien-Hsing; Chang, Nen-Chung

doi:10.1097/psy.0000000000000666

Cited by 26 publications

(24 citation statements)

References 49 publications

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“…The highest scores correspond to the most negative affective states. Thus, the stress subscale has no signs and/or symptoms (0-14), mild (15)(16)(17)(18), moderate (19)(20)(21)(22)(23)(24)(25), severe (26-33) and extreme (> 33). The subscale of anxiety has no signs and/or symptoms (0-7), mild (8)(9), moderate (10)(11)(12)(13)(14), severe (15)(16)(17)(18)(19) and extreme (>19).…”

Section: Methodsmentioning

confidence: 99%

“…19,20 Because it is a prevalent disease, current research is seeking to identify factors that may be associated with diabetes. 21 Among these factors, the presence of historical anxiety and/or depression stands out, which besides being precursors for diabetes, are also involved in the emergence of coronary diseases and the recurrence of psychopathologies. 21 These data were ratified by the current study.…”

Section: Concludedmentioning

confidence: 99%

“…21 Among these factors, the presence of historical anxiety and/or depression stands out, which besides being precursors for diabetes, are also involved in the emergence of coronary diseases and the recurrence of psychopathologies. 21 These data were ratified by the current study. The permanence, onset or increased use of sleeping medications during the pandemic was considered a risk association for signs and symptoms of severe/extreme stress.…”

Section: Concludedmentioning

confidence: 99%

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Factors associated with psychic symptomatology in diabetics during the COVID-19 pandemic

Souza

Praciano

Neto

et al. 2021

Rev. Bras. Saude Mater. Infant.

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Objectives: to determine the frequency and factors associated with severe / extreme signs and symptoms of stress, anxiety and depression in diabetic patients during the COVID-19 pandemic. Methods: cross-sectional study conducted in April /May 2020, which included 162 individuals with diabetes mellitus and over 18 years old. An online questionnaire was applied on social networks, composed of biological, sociodemographic, clinical characteristics and the Stress, Anxiety and Depression Scale (DASS-21). For statistical analysis, a multivariate logistic regression model was applied with a 5% significance level. Results: frequency of 37.7%, 43.3% and 45.1% were found for some symptom of stress, anxiety and depression, respectively. The factors associated with sign and symptoms of severe / extreme psychic disorders were: not having religion (stress, anxiety and depression); be at graduation (stress and anxiety); history of anxiety and depression (anxiety and depression); not practicing or decreasing physical exercises and starting, increased or continue taking sleeping medications (stress); history of contact with a suspected case of COVID-19, absence or decreased leisure (anxiety); female gender, absence of a partner, decreased family income and work or study (depression). Conclusion: the frequency of psychological disorders was higher than described in the literature on diabetic patients, being associated with biological, sociodemographic, clinical factors and aspects related to COVID-19 during the pandemic

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Section: Methodsmentioning

confidence: 99%

Section: Concludedmentioning

confidence: 99%

Section: Concludedmentioning

confidence: 99%

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Factors associated with psychic symptomatology in diabetics during the COVID-19 pandemic

Souza

Praciano

Neto

et al. 2021

Rev. Bras. Saude Mater. Infant.

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“…In this issue of Psychosomatic Medicine, Hung et al describe the association of anxiety and depression with CAS in a large retrospective cohort study based on the Taiwanese National Health Insurance Research Database (24). They used propensity score matching for the period between 2000 and 2012 to identify three groups: 10,473 patients with CAS; 10,473 patients with obstructive CAD; and 10,325 controls with no CAS and no obstructive CAD.…”

mentioning

confidence: 99%

Coronary Artery Spasm, Coronary Reactivity, and Their Psychological Context

2019

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Symptomatic individuals suspected of having myocardial ischemia often have no obstructive atherosclerotic narrowing of epicardial coronary arteries. Abnormal coronary vascular reactivity, and in particular, coronary artery vasospasm (CAS), may be an explanation in a subset of these patients. Psychological factors play an important role in ischemic heart disease, but their role in CAS is not clear; autonomic dysfunction and increased inflammation are two prevailing pathophysiological mechanisms implicated in abnormal coronary reactivity resulting from mental health conditions. Interrelationships between psychological factors, abnormal coronary reactivity, and sex/gender differences are poorly defined in the etiology of CAS. In this issue of Psychosomatic Medicine, Hung et al. report a frequency of less than 0.1% of new onset CAS in the Taiwanese population, with higher occurrence in women and younger individuals. Patients with CAS had a higher prevalence of prior anxiety and depression compared to those with coronary artery disease and controls, with no sex differences. In this editorial comment, we discuss the potential reasons for underreporting of CAS and the challenges regarding the use of administrative health records for psychosomatic research. In this editorial, a model is presented to explain the association between emotional stressors and mental health factors with CAS, including the role of sympathetic nervous system activation, inflammation, oxidative stress, endothelial dysfunction, and smooth muscle cell dysregulation.

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“…The CAS group comprised adult patients (≥20 years) with newly-diagnosed CAS (ICD-9-CM code 4131), with at least 3 outpatient diagnoses or 1 inpatient diagnosis between January 1, 2000 and December 31, 2012 in the NHIRD of the entire Taiwanese population because the prevalence of CAS was not high. The de nition of CAS in the NHIRD has been previously reported [18]. Subjects in the control group were identi ed from a subset of the NHIRD, the Longitudinal Health Insurance Database 2000, which consists of claims data from 1 million randomly sampled people who were alive during the year 2000 and had been followed up from 1997 to 2012.…”

Section: Study Design and Subjectsmentioning

confidence: 99%

Coronary Artery Spasm is Associated With an Increased Risk of Incident Diabetes: A Nationwide Population-Based Cohort Study

Hung¹,

Chang²,

Hu³

et al. 2020

Preprint

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BackgroundNon-diabetic coronary artery spasm (CAS) without obstructive coronary artery disease increases insulin resistance. We investigated the risk of incident type 2 diabetes (diabetes) associated with CAS.MethodsPatient records were retrospectively collected from the Taiwan National Health Insurance Research Database during the period 2000-2012. The matched cohorts consisted of 12,413 patients with CAS and 94,721 patients in the control group. ResultsDuring the entire follow-up, the incidence of newly-diagnosed diabetes was 22.2 events per 1000 person-years in the CAS group and 13.9 events per 1000 person-years in the control group. The increased risk of CAS-related incident diabetes was observed regardless of sex and length of follow-up. The median time to incident diabetes was 2.9 and 3.5 years in the CAS and the control group (P <0.001), respectively, regardless of sex. Although age did not affect the risk of CAS-related incident diabetes, the risk was less apparent in the subgroups of male, dyslipidemia, chronic obstructive pulmonary disease, stroke, gout and medicated hypertension. However, CAS patients aged <50 years compared with patients ≥50 years had a greater risk of incident diabetes in females but not in males. Older CAS patients developed diabetes in a shorter length of time than younger patients.ConclusionCAS is a risk factor for incident diabetes regardless of sex. However, females aged <50 years have a more apparent risk for CAS-related diabetes than old females, which is not observed in males. The median time of 2.9 years to incident diabetes warrants close follow-up.

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Coronary Artery Spasm as Related to Anxiety and Depression: A Nationwide Population-Based Study

Cited by 26 publications

References 49 publications

Factors associated with psychic symptomatology in diabetics during the COVID-19 pandemic

Factors associated with psychic symptomatology in diabetics during the COVID-19 pandemic

Coronary Artery Spasm, Coronary Reactivity, and Their Psychological Context

Coronary Artery Spasm is Associated With an Increased Risk of Incident Diabetes: A Nationwide Population-Based Cohort Study

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