Anxiety is Related to Increased Carotid Intima-Media Thickness in Patients with First Acute Myocardial Infarction

Purpose: We examined the association of anxiety and depression with carotid intima media thickness in CAD patients during their hospitalization for acute myocardial infarction (MI). Methods: A cohort of 74 consecutive patients (age: 59±10, range: 30 to 75 years) with a first episode of myocardial infarction (MI) (64% STEMI and 36% Non STEMI) were included. Mean intima-media thickness (IMT) in common carotids and carotid bulbs using ultrasound imaging was measured at study entry. All patients completed the Hospital Anxiety and Depression Scale (HADS) in the first 3 days of admission and the corresponding anxiety and depression scores were calculated. Patients were interviewed according to the structured clinical interview of the DSM-IV masked to the self-reports of symptoms. Results: Patients with MI and pre-infarction angina had a higher incidence of anxiety (75% vs. 25% P<0.01) compared to those without. There were no difference in atherosclerotic risk factors medication and socioeconomic status, location of MI and STEMI between patients with (n=49 (67%)) and without anxiety. However patients with anxiety had increased IMT compared to those without (0.1 ±0.01 vs. 0.08 ±0.01 cm p<0.05). The anxiety score as assessed by HADS was related with IMT (r=0.40 p<0.01). After adjustment for atherosclerotic risk factors, (hyperlipidemia, diabetes, smoking, hypertension, socioeconomic status and medication), anxiety was independently associated with increased IMT values (b regression coefficient =0.37 p<0.05). Conclusion: The present study suggests that increased anxiety is an independent determinant of IMT, an established surrogate marker of atherosclerosis, in patients with acute myocardial infarction.