• Mohammad Asghar Khan
  • Mehwish Karamat
  • Mohammad Hafizullah
  • Zahid Nazar
  • Muhammad Fahim
  • Adnan Mehmood Gul


Background: The impact of psychological factors in acute coronary events is only now emerging. Agrowing body of evidence attests to the influence of emotional and stress-related psychosocialfactors in the aetiology of Coronary Artery Disease (CAD) and morbidity and mortality amongindividuals with coronary heart disease. The objectives were to look for the frequency of anxiety andpsychosocial stressful events in patients with acute myocardial infarction. Methods: Two hundredconsecutive patients of Acute Myocardial Infarction (AMI) without complications who presented tothe Coronary Care Unit of Cardiology Department, Lady Reading Hospital Peshawar, and 200healthy controls among relatives of patients were assessed on Holmes Rahe Social scale (HRS) andHospital Anxiety and Depression Scale (HADS) scale for the presence of anxiety and stressful lifeevents in period preceding AMI. Results: Sixty-three percent of the patients were male in bothgroups. Mean age of patients was 59 years while that of controls was 52 years. For scores of anxietyon HADS, 34% of the controls had normal score compared to of the 19% AMI group (p<0.001),while 57% of the AMI patients had abnormal score compared to 39% of the control group (p<0.001).The number events reported on HRS scale in patients with AMI were significantly more (4.2±2)compared to the number of events (2.7±1.6) in the control group with (p<0.001). Scores for thenumber of events on HRS scale were significantly less (98±64) in controls compared to (158±5.8) ingroup with AMI (p<0.001). Anxiety was diagnosed in 70% of the female patients compared to 50%of the male patients. Conclusion: Significant number of patients with acute myocardial infarctionwhen assessed on standard scales had anxiety and stressful life events in the weeks preceding theevent. These were more common in female than male patients.Keywords: Anxiety, Stress, Myocardial Infarction, Coronary, HADS


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