Myocardial infarction patients may benefit from having anxiety

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Karl-Heinz Ladwig (Technical University of Munich and Helmholtz Zentrum München, Munich, Germany) and his fellow investigators have found that anxiety may be an effective protective mechanism in acute emergencies. They found patients with anxiety were more likely to quickly respond to a myocardial infarction and arrive at the emergency room sooner

Using data from the MEDEA (Munich examination of delay in patients experiencing acute myocardial infarction) study, Ladwig et al reviewed data for 619 myocardial infarction patients. In MEDEA, patients were interviewed in hospital, within 24 hours of leaving the intensive care unit. Other data such as the time of arrival at the hospital and the course of the disease was also used in Ladwig et al’s study.

Ladwig et al found that about 12% of patients in the study had an anxiety disorder and these patients more quickly reacted to an acute myocardial infarction and arrived at the emergency room sooner. The time difference between female heart attack patients with and without anxiety disorder was particularly marked—on average, the former reached a hospital 112 minutes after the onset of a myocardial infarction, while their counterparts without anxiety disorder took around two hours longer. Many scientific studies have shown that every half hour is crucial for survival following an acute myocardial infarction.

The authors were, however, only able to statistically demonstrate the protective effect of anxiety in women, not in men. Nevertheless, a positive trend was observed in men with an anxiety disorder—such men were treated within 48 minutes earlier on average.

Ladwig comments: “Individuals with anxiety disorder are at greater risk of having a heart attack but are more likely to survive it. Our data revealed an important factor. Individuals with anxiety disorder often react more sensitively to their health needs. Doctors should always take their concerns very seriously. Such patients are also more decisive when it comes to accepting help. In this way, one illness can help protect against another serious illness.”

Nevertheless, as the study also showed, the psychological costs of this survival advantage are high: patients with anxiety disorder suffer significantly more from stress, extreme fatigue and impaired general well-being than those without anxiety.

According to Ladwig et al, further studies should investigate the role of cultural differences and they are planning a similar study in Shanghai.

The study was published in Clinical Research in Cardiology.


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