ArticleInternational journal of cardiology2013
Anxiety associations with cardiac symptoms, angiographic disease severity, and healthcare utilization: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation.
Article in International journal of cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Economic Burden of Anxiety Disorders: A Systematic Review and Meta-Analysis.PharmacoEconomics · 2020Pooled it
- Patient-Reported Symptoms of Acute Coronary Syndrome in the Prehospital Period in a Prospective Study: Implications for Emergency Nurse Triage, Diagnosis, and Clinical Outcomes.Journal of emergency nursing · 2025Article
- Coronary Microvascular Dysfunction and Vasospastic Angina-Pathophysiology, Diagnosis and Management Strategies.Journal of clinical medicine · 2025Review
- A nomogram to distinguish noncardiac chest pain based on cardiopulmonary exercise testing in cardiology clinic.BMC medical informatics and decision making · 2024Article
- Exploring the Link Between Interoception and Symptom Severity in Premature Ventricular Contractions.Journal of clinical medicine · 2024Article
- Latest from the WISE: Contributions to the Understanding of Ischemia and Heart Failure among Women with No Obstructive Coronary Arteries.Reviews in cardiovascular medicine · 2023Review
- Cardiovascular disease and subsequent risk of psychiatric disorders: a nationwide sibling-controlled study.eLife · 2022Article
- Younger Age Impacts Perceptions of Care Received in the Emergency Department Among Women with Spontaneous Coronary Artery Dissection.Journal of women's health (2002) · 2022Article
- Psychological factors of suspect coronary microvascular dysfunction in patients undergoing SPECT imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Heart-Focused Anxiety Affects Behavioral Cardiac Risk Factors and Quality of Life: A Follow-Up Study Using a Psycho-Cardiological Rehabilitation Concept.Frontiers in psychiatry · 2022Article
- Anxiety and hemodynamic reactivity during cardiac stress testing: The role of gender and age in myocardial ischemia.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- The Role of Mental Stress in Ischaemia with No Obstructive Coronary Artery Disease and Coronary Vasomotor Disorders.European cardiology · 2021Review
- Even "WISE-R?"-an Update on the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation.Current atherosclerosis reports · 2020Review
- Mental stress peripheral vascular reactivity is elevated in women with coronary vascular dysfunction: Results from the NHLBI-sponsored Cardiac Autonomic Nervous System (CANS) study.International journal of cardiology · 2018Article
- Psychosocial predictors of long-term mortality among women with suspected myocardial ischemia: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation.Journal of behavioral medicine · 2016Article
- Investigation of anxiety levels of patients with chest pain admitted to emergency department.Turkish journal of emergency medicine · 2015Article
- Prevalence and implications of severe anxiety in a prospective cohort of acute chest pain patients.Critical pathways in cardiology · 2015Article
- Relations between depressive symptoms, anxiety, and T Wave abnormalities in subjects without clinically-apparent cardiovascular disease (from the Multi-Ethnic Study of Atherosclerosis [MESA]).The American journal of cardiology · 2014Article
- Clinical implications of the Women's Ischemia Syndrome Evaluation: inter-relationships between symptoms, psychosocial factors and cardiovascular outcomes.Women's health (London, England) · 2013Review
Corrections and comments
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAnxiety is common among patients presenting with suspected coronary artery disease (CAD). In a sample of women with signs and symptoms of ischemia, we examined three anxiety markers as predictors of CAD endpoints including: 1) cardiac symptom indicators; 2) angiographic CAD severity; and 3) healthcare utilization (cardiac hospitalizations and 5-year cardiovascular [CVD] healthcare costs).
methodsParticipants completed a baseline protocol including coronary angiogram, cardiac symptoms, psychosocial measures and a median 5.9-year follow-up to track hospitalizations. We calculated CVD costs based on cardiac hospitalizations, treatment visits, and CVD medications. Anxiety measures included anxiolytic medication use, Spielberger Trait Anxiety Inventory (STAI) scores, and anxiety disorder treatment history.
resultsThe sample numbered 514 women with anxiety measure data and covariates (mean age=57.5 [11.1]). One in five (20.4%) women reported using anxiolytic agents. Anxiety correlated with cardiac symptom indicators (anxiolytic use with nighttime angina and nitroglycerine use; STAI scores and anxiety disorder treatment history with nighttime angina, shortness of breath, and angina frequency). Anxiety disorder treatment history (but not STAI scores or anxiolytics) predicted less severe CAD. Anxiolytic use (but not STAI scores or anxiety disorder treatment history) predicted hospitalizations for chest pain and coronary catheterization (HRs=2.0, 95% CIs=1.1-4.7). Anxiety measures predicted higher 5-year CVD costs (+9.0-42.7%) irrespective of CAD severity.
conclusionsAmong women with signs and symptoms of myocardial ischemia, anxiety measures predict cardiac endpoints ranging from cardiac symptom severity to healthcare utilization. Based on these findings, anxiety may warrant greater consideration among women with suspected CAD.
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