DENVER – Phobic anxiety was significantly associated with both ventricular arrhythmia and mortality in coronary artery disease patients during a median 3-year follow-up, said Lana Watkins, Ph.D., at the annual meeting of the American Psychosomatic Society.
The relationship between sudden cardiac death and phobic anxiety in particular has not been well studied, Dr. Watkins noted. She and her colleagues at Duke University Medical Center in Durham, N.C., evaluated 941 adult patients who were being treated for coronary artery disease. A majority of these patients were white males. About a third of the patients did not have high school diplomas, and smoking and obesity were common among patients in the study.
The highest number of arrhythmias occurred among those patients with the highest levels of phobic anxiety based on the Crown-Crisp index, which rates eight types of phobias, including fear of heights, crowds, and closed spaces.
Overall, the highest tertile of phobic anxiety scores had twice as many females as males, and a higher level of phobic anxiety was significantly associated with female sex, minority status, increased body mass index, and younger age.
Despite the finding of an association between phobic anxiety and ventricular arrhythmias, no significant relationship was found between phobic anxiety and sudden cardiac death, Dr. Watkins noted. During a follow-up period, 134 patients died, and 46 of these met the criteria for sudden cardiac death. Sudden cardiac death was defined as death within 72 hours of collapse, in order to account for deaths of patients who lived alone.
However, mortality was highest among patients with high levels of phobic anxiety, Dr. Watkins said. The predictability of phobic anxiety for both mortality and an increased risk of ventricular arrhythmias was maintained in a regression analysis after other predictors of mortality including age, gender, education level, and comorbidities were adjusted for.