• Hsin-Pei Feng, Wu-Chien Chien, Wei-Tung Cheng, Chi-Hsiang Chung, Shu-Meng Cheng, and Wen-Chii Tzeng.
• Institute of Medical Sciences and School of Nursing, National Defense Medical Center, Taipei City, Taiwan (ROC) Department of Medical Research, Tri-Service General Hospital and School of Public Health, National Defense Medical Center, Taipei City, Taiwan (ROC) Kaohsiung Armed Forces General Hospital Gangshan Branch, Kaohsiung CityTaiwan (ROC) Taiwanese Injury Prevention and Safety Promotion Association, School of Public Health, National Defense Medical Center, Taipei City, Taiwan (ROC) Internal Medicine, School of Medicine and Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan (ROC) School of Nursing, National Defense Medical Center, Taipei City, Taiwan (ROC).
• Medicine (Baltimore). 2016 Aug 1; 95 (34): e4464.

AbstractAnxiety and depressive symptoms are associated with adverse cardiovascular events after an acute myocardial infarction (MI). However, most studies focusing on anxiety or depression have used rating scales or self-report methods rather than clinical diagnosis. This study aimed to investigate the association between psychiatrist-diagnosed psychiatric disorders and cardiovascular prognosis.We sampled data from the National Health Insurance Research Database; 1396 patients with MI were recruited as the study cohort and 13,960 patients without MI were recruited as the comparison cohort. Cox proportional hazard regression models were used to examine the effect of MI on the risk of anxiety and depressive disorders.During the first 2 years of follow-up, patients with MI exhibited a significantly higher risk of anxiety disorders (adjusted hazard ratio [HR] = 5.06, 95% confidence interval [CI]: 4.61-5.54) and depressive disorders (adjusted HR = 7.23, 95% CI: 4.88-10.88) than those without MI did. Greater risk for anxiety and depressive disorders was observed among women and patients aged 45 to 64 years following an acute MI. Patients with post-MI anxiety had a 9.37-fold (95% CI: 4.45-19.70) higher risk of recurrent MI than those without MI did after adjustment for age, sex, socioeconomic status, and comorbidities.This nationwide population-based cohort study provides evidence that MI increases the risk of anxiety and depressive disorders during the first 2 years post-MI, and post-MI anxiety disorders are associated with a higher risk of recurrent MI.

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