Volume 5, Issue 4 (Autumn 2017)                   Iran J Health Sci 2017, 5(4): 1-9 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Wan-Nor-Asyikeen W A, Siti-Azrin A H, Sulong Z R, Hashairi Fauzi M. Associated Factors of Anxiety among Acute Coronary Syndrome Patients in Kelantan and Terengganu. Iran J Health Sci 2017; 5 (4) :1-9
URL: http://jhs.mazums.ac.ir/article-1-507-en.html
School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
Abstract:   (4843 Views)
Background and purpose: Anxiety is a common condition among acute coronary syndrome patients. This syndrome often goes unrecognised and can persist for months to years, while impacting substantially the quality of life. Therefore, this study aimed to identify the associated factor of anxiety among acute coronary syndrome patients in Hospital Universiti Sains Malaysia and Hospital Sultanah Nur Zahirah.
Materials and Methods: This cross-sectional study involved acute coronary syndrome patients admitted to Hospital Universiti Sains Malaysia, Kelantan and Hospital Sultanah Nur Zahirah, Terengganu between August 2014 and May 2015. A standardised questionnaire was developed to interview the respondents. The questionnaire was separated into two sections. The first section comprised the socio-demographic details of the patients. The second section was the validated Depression Anxiety Stress Scale 21 (DASS-21) questionnaire. Simple and multiple logistic regressions were used for analysing the collected data.
Results: The mean (standard deviation (SD)) age of acute coronary syndrome patients was 60.4 (11.3) years and 61.2 (10.4) years in Hospital Universiti Sains Malaysia and Hospital Sultanah Nur Zahirah respectively. The majority of acute coronary syndrome patients who experienced anxiety were male (86.3%) with 84.9% of them Malay ethnicity and 85.9% of them married. The factor associated with anxiety among acute coronary syndrome patients was having a history of ischemic heart disease (adjusted odd ratio (OR): 2.20, as well as confidence interval (CI): 1.19, 4.10, p=0.013).
Conclusion: It was concluded that anxiety had myriad effects on cardiovascular physiology, which plays an important role in the increased incidence of ischemic events in patients. A screening tool should be created to refine and identify the psychological status of acute coronary syndrome patients, so that early treatment could be given.
Full-Text [PDF 309 kb]   (1574 Downloads)    
Type of Study: Original Article | Subject: Nursing

1. Azman WW, Sim KH. Annual report of the acute coronary syndrome (ACS) registry 2007 & 2008.
2. Alwan A. Global status report on non-communicable diseases 2010. World Health Organization; 2011.
3. Bankier B, Barajas J, Martinez-Rumayor A, Januzzi JL. Association between C-reactive protein and generalized anxiety disorder in stable coronary heart disease patients. European heart journal. 2008 Jul 4; 29(18):2212-7. [DOI:10.1093/eurheartj/ehn326] [PMID]
4. Brennan AM, Fargnoli JL, Williams CJ, Li T, Willett W, Kawachi I, Qi L, Hu FB, Mantzoros CS. Phobic anxiety is associated with higher serum concentrations of adipokines and cytokines in women with diabetes. Diabetes care. 2009 May 1; 32(5):926-31. [DOI:10.2337/dc08-1979] [PMID] [PMCID]
5. Brown TA, Chorpita BF, Korotitsch W, Barlow DH. Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour research and therapy. 1997 Jan 31; 35(1):79-89. [DOI:10.1016/S0005-7967(96)00068-X]
6. Chin SP, Jeyaindran S, Azhari R, Wan Azman WA, Omar I, Robaayah Z, Sim KH. Acute coronary syndrome (ACS) registry-leading the charge for National Cardiovascular Disease (NCVD) Database. Medical Journal of Malaysia. 2008 Sep; 63(Suppl C):29-36. [PMID]
7. Colman AM. A dictionary of psychology. Oxford University Press, USA; 2015.
8. Crowe JM, R:union:s J, Ebbesen LS, Oldridge NB, Streiner DL. Anxiety and depression after acute myocardial infarction. Heart & Lung: The Journal of Acute and Critical Care. 1996 Mar 1; 25(2):98-107. [DOI:10.1016/S0147-9563(96)80111-7]
9. de Jager J, Dekker JM, Kooy A, Kostense PJ, Nijpels G, Heine RJ, Bouter LM, Stehouwer CD. Endothelial dysfunction and low-grade inflammation explain much of the excess cardiovascular mortality in individuals with type 2 diabetes. Arteriosclerosis, thrombosis, and vascular biology. 2006 May 1; 26(5):1086-93. [DOI:10.1161/01.ATV.0000215951.36219.a4] [PMID]
10. Doering LV, Moser DK, Riegel B, McKinley S, Davidson P, Baker H, Meischke H, Dracup K. Persistent comorbid symptoms of depression and anxiety predict mortality in heart disease. International journal of cardiology. 2010 Nov 19; 145(2):188-92. [DOI:10.1016/j.ijcard.2009.05.025] [PMID] [PMCID]
11. Eng HS, Yean LC, Das S, Letchmi S, Yee KS, Bakar RA, Hung J, Choy CY. Anxiety and depression in patients with coronary heart disease: a study in a tertiary hospital. Iranian journal of medical sciences. 2011 Sep; 36(3):201. [PMID] [PMCID]
12. Fan AZ, Strine TW, Jiles R, Mokdad AH. Depression and anxiety associated with cardiovascular disease among persons aged 45 years and older in 38 states of the United States, 2006. Preventive medicine. 2008 May 31; 46(5):445-50. [DOI:10.1016/j.ypmed.2008.02.016] [PMID]
13. Fischer D, Rossa S, Landmesser U, Spiekermann S, Engberding N, Hornig B, Drexler H. Endothelial dysfunction in patients with chronic heart failure is independently associated with increased incidence of hospitalization, cardiac transplantation, or death. European heart journal. 2004 Nov 23; 26(1):65-9. [DOI:10.1093/eurheartj/ehi001] [PMID]
14. Geiser F, Meier C, Wegener I, Imbierowicz K, Conrad R, Liedtke R, Oldenburg J, Harbrecht U. Association between anxiety and factors of coagulation and fibrinolysis. Psychotherapy and psychosomatics. 2008; 77(6):377-83. [DOI:10.1159/000151518] [PMID]
15. Grace SL, Abbey SE, Irvine J, Shnek ZM, Stewart DE. Prospective examination of anxiety persistence and its relationship to cardiac symptoms and recurrent cardiac events. Psychotherapy and psychosomatics. 2004; 73(6):344-52. [DOI:10.1159/000080387] [PMID]
16. Hanssen TA, Nordrehaug JE, Eide GE, Bjelland I, Rokne B. Anxiety and depression after acute myocardial infarction: an 18-month follow-up study with repeated measures and comparison with a reference population. European Journal of Cardiovascular Prevention & Rehabilitation. 2009 Dec; 16(6):651-9. [DOI:10.1097/HJR.0b013e32832e4206] [PMID]
17. Hoehn-Saric R, McLeod DR, Funderburk F, Kowalski P. Somatic symptoms and physiologic responses in generalized anxiety disorderand panic disorder: An ambulatory monitor study. Archives of General Psychiatry. 2004 Sep 1; 61(9):913-21. [DOI:10.1001/archpsyc.61.9.913] [PMID]
18. Huffman JC, Celano CM, Januzzi JL. The relationship between depression, anxiety, and cardiovascular outcomes in patients with acute coronary syndromes. Neuropsychiatric Disease and treatment. 2010; 6:123. [DOI:10.2147/NDT.S6880] [PMID] [PMCID]
19. IBM Corporation 2013.
20. Katz SD, Hryniewicz K, Hriljac I, Balidemaj K, Dimayuga C, Hudaihed A, Yasskiy A. Vascular endothelial dysfunction and mortality risk in patients with chronic heart failure. Circulation. 2005 Jan 25; 111(3):310-4. [DOI:10.1161/01.CIR.0000153349.77489.CF] [PMID]
21. Kretchy IA, Owusu-Daaku FT, Danquah SA. Mental health in hypertension: assessing symptoms of anxiety, depression and stress on anti-hypertensive medication adherence. International journal of mental health systems. 2014 Jun 21; 8(1):25. [DOI:10.1186/1752-4458-8-25] [PMID] [PMCID]
22. Kubzansky LD, Davidson KW, Rozanski A. The clinical impact of negative psychological states: expanding the spectrum of risk for coronary artery disease. Psychosomatic medicine. 2005 May 1; 67:S10-4. [DOI:10.1097/01.psy.0000164012.88829.41] [PMID]
23. Kubzansky L, Kawachi I, Spiro A. Is Worrying Bad for Your Heart? A Prospective Study of Worry and Coronary Heart Disease in the Normative Aging Study. Year Book of Psychiatry and Applied Mental Health. 1998 Jan 1; 1998(8):341-2.
24. Kubzansky LD, Kawachi I, Spiro A, Weiss ST, Vokonas PS & Sparrow D. Is worrying bad for your heart? A prospective study of worry and coronary heart disease in the Normative Aging Study. Circulation 1997; 95(4): 818-24. [DOI:10.1161/01.CIR.95.4.818] [PMID]
25. Kumar A, Cannon CP. Acute coronary syndromes: diagnosis and management, part I. InMayo Clinic Proceedings 2009 Oct 31 (Vol. 84, No. 10, pp. 917-938). Elsevier.
26. Lane D, Carroll D, Ring C, Beevers DG, Lip GY. Mortality and quality of life 12 months after myocardial infarction: effects of depression and anxiety. Psychosomatic Medicine. 2001 Mar 1; 63(2):221-30. [DOI:10.1097/00006842-200103000-00005] [PMID]
27. Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, Ferguson TB, Ford E, Furie K, Gillespie C, Go A. Heart disease and stroke statistics—2010 update. Circulation. 2010 Feb 23; 121(7):e46-215. [DOI:10.1161/CIRCULATIONAHA.109.192667] [PMID]
28. Malaysia MoH. Health Facts 2013. Health Informatics Centre. Planning Division, Ministry of Health Malaysia 2013.
29. Miyata K, Shimokawa H, Higo T, Yamawaki T, Katsumata N, Kandabashi T, Tanaka E, Takamura Y, Yogo K, Egashira K, Takeshita A. Sarpogrelate, a selective 5-HT2A serotonergic receptor antagonist, inhibits serotonin-induced coronary artery spasm in a porcine model. Journal of cardiovascular pharmacology. 2000 Feb 1; 35 (2):294-301. [DOI:10.1097/00005344-200002000-00018] [PMID]
30. Murphy BM, Elliott PC, Worcester MU, Higgins RO, Grande MR, Roberts SB, Goble AJ. Trajectories and predictors of anxiety and depression in women during the 12 months following an acute cardiac event. British journal of health psychology. 2008 Feb 1; 13(1):135-53. [DOI:10.1348/135910707X173312] [PMID]
31. Musa RA, Fadzil MA, Zain ZA. Translation, validation and psychometric properties of Bahasa Malaysia version of the Depression Anxiety and Stress Scales (DASS). ASEAN Journal of Psychiatry. 2007;8(2):82-9.
32. Narita K, Murata T, Hamada T, Takahashi T, Kosaka H, Yoshida H, Wada Y. Association between trait anxiety and endothelial function observed in elderly males but not in young males. International psychogeriatrics. 2007 Oct; 19(5):947-54. [DOI:10.1017/S1041610206004571] [PMID]
33. Narita K, Murata T, Hamada T, Takahashi T, Omori M, Suganuma N, Yoshida H, Wada Y. Interactions among higher trait anxiety, sympathetic activity, and endothelial function in the elderly. Journal of psychiatric research. 2007 Aug 31; 41(5):418-27. h [DOI:10.1016/j.jpsychires.2006.01.003] [PMID]
34. Overbaugh KJ. Acute coronary syndrome. AJN The American Journal of Nursing. 2009 May 1; 109(5):42-52. [DOI:10.1097/01.NAJ.0000351508.39509.e2] [PMID]
35. Pedersen SS, Smith OR, De Vries J, Appels A, Denollet J. Course of anxiety symptoms over an 18-month period in exhausted patients post percutaneous coronary intervention. Psychosomatic medicine. 2008 Apr 1; 70(3):349-55. [DOI:10.1097/PSY.0b013e3181656540] [PMID]
36. Pitsavos C, Panagiotakos DB, Papageorgiou C, Tsetsekou E, Soldatos C, Stefanadis C. Anxiety in relation to inflammation and coagulation markers, among healthy adults: the ATTICA study. Atherosclerosis. 2006 Apr 30; 185(2):320-6. [DOI:10.1016/j.atherosclerosis.2005.06.001] [PMID]
37. Roth WT, Doberenz S, Dietel A, Conrad A, Mueller A, Wollburg E, Meuret AE, Taylor CB, Kim S. Sympathetic activation in broadly defined generalized anxiety disorder. Journal of psychiatric research. 2008 Feb 29; 42(3):205-12. [DOI:10.1016/j.jpsychires.2006.12.003] [PMID] [PMCID]
38. Rothenbacher D, Hahmann H, Wüsten B, Koenig W, Brenner H. Symptoms of anxiety and depression in patients with stable coronary heart disease: prognostic value and consideration of pathogenetic links. European Journal of Cardiovascular Prevention & Rehabilitation. 2007 Aug; 14(4):547-54. [DOI:10.1097/HJR.0b013e3280142a02] [PMID]
39. Vikenes K, Farstad M, Nordrehaug JE. Serotonin is associated with coronary artery disease and cardiac events. Circulation. 1999 Aug 3; 100(5):483-9. [DOI:10.1161/01.CIR.100.5.483] [PMID]
40. Vural M, Acer M, Akbaš B. The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi. 2008 Feb 1; 8(1).
41. Perkins-Porras L, Whitehead DL, Strike PC, Steptoe A. Pre-hospital delay in patients with acute coronary syndrome: factors associated with patient decision time and home-to-hospital delay. European Journal of Cardiovascular Nursing. 2009 Mar; 8(1):26-33. [DOI:10.1016/j.ejcnurse.2008.05.001] [PMID] [PMCID]
42. World Health Organization. World Health Organization (WHO)-Malaysia: country cooperation strategy 2009-2013.

Add your comments about this article : Your username or Email:

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2023 CC BY-NC 4.0 | Iranian Journal of Health Sciences

Designed & Developed by : Yektaweb