Delewi Ronak, Vlastra Wieneke, Rohling Wim J, Wagenaar Tineke C, Zwemstra Max, Meesterman Martin G, Vis Marije M, Wykrzykowska Joanna J, Koch Karel T, de Winter Robbert J, Baan Jan, Piek Jan J, Sprangers Mirjam A G, Henriques José P S
Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Int J Cardiol. 2017 Feb 1;228:926-930. doi: 10.1016/j.ijcard.2016.11.043. Epub 2016 Nov 11.
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.
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.
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.
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.
冠心病患者的高焦虑水平与更差的预后相关。对于接受冠状动脉手术的患者的焦虑水平知之甚少。我们的目的是研究接受冠状动脉造影（CAG）或经皮冠状动脉介入治疗（PCI）的患者在住院不同阶段的焦虑水平，并评估哪些患者特征与焦虑增加相关。
本前瞻性队列研究纳入了2009年4月至2010年4月期间接受CAG或PCI的患者。使用自我报告的焦虑视觉模拟量表（VAS）测量焦虑水平，范围为0至100。在入院时、手术前后以及出院时获得VAS焦虑评分。进行多变量线性回归分析以评估基线特征与不同时间点焦虑水平之间的相关性。
共纳入2604例患者，其中70.4%为男性参与者，平均年龄为65±12岁。VAS焦虑评分在手术前最高（44.2±27.0mm）。与男性（41.5±26.8，p = 0.02）相比，女性患者术前VAS焦虑评分显著更高（50.4±26.5）。在不同时间点与较高焦虑水平相关的其他因素包括年龄<65岁、低教育水平和急性直接PCI。
在迄今为止最大的队列中，我们研究发现接受PCI或CAG的患者在手术前后焦虑程度最高，尤其是年龄<65岁、女性、接受直接PCI或教育水平较低的患者。更好的术前信息或药物策略可能会降低这些患者的焦虑。
