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P.F Cromhout, A.V.C Christensen, M.B.J Joergensen, O.E Ekholm, K.J Juel, J.H.S Svendsen, T.B.R Rasmussen, B.B Borregaard, R.E.M Mols, L.T Thrysoee, C.B.T Thorup, S.K.B Berg, The association between anxiety measured with HADS and use of psychotropic medication among cardiac patients, European Heart Journal, Volume 41, Issue Supplement_2, November 2020, ehaa946.3435, https://doi.org/10.1093/ehjci/ehaa946.3435
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Abstract
Anxiety among cardiac patients is highly prevalent and is associated to poor outcomes. Certain types of psychotropic medication are suspected of causing adverse events in cardiac patients. However, an association between symptoms of anxiety and use of psychotropic medication among cardiac patients has not yet been established.
The objective was to explore the association between anxiety (measured by HADS-A) and use of psychotropic medication among cardiac patients.
All study participant were identified from the DenHeart study and data were a combination of patient-reported survey data and baseline and follow-up data from Danish national registers. Information on redeemed prescriptions of psychotropic medication was obtained from The Danish National Prescription Registry. Anxiety symptoms were defined by a HADS-A score≥8. Patients were defined as users of psychotropic medication if they had redeemed at least one prescription one and three years after discharge. Psychotropic medication was classified by Anatomical Therapeutic Chemical Classification (ATC) codes.
Multiple logistic regression analysis within one year and Cox regression analysis within three year from discharge was conducted to determine the association between symptoms of anxiety and use of psychotropic medication.
Among the 12,913 cardiac patients included, a total of 3231 (28%) redeemed at least one prescription of psychotropic medication within one year and 4726 (37%) within three years after discharge. The most commonly used drugs were benzodiazepines and antidepressants. Among patients using psychotropic medication 1481 (46%) had a HADS-A score ≥8. Cardiac patients with symptoms of anxiety had significantly higher odds of using psychotropic medication within one year from discharge OR 2.47 (95% CI 2.25; 2.72). The increased risk of use of psychotropic medication was confirmed with a almost two-fold risk after three years, HR 1.92 (95% CI 1.80; 2.04), Table 1.
Cardiac patients with symptoms of anxiety measured by HADS were significantly more likely to use psychotropic medication within one and three years after discharge than cardiac patients without symptoms of anxiety.
Table 1. Association between symptoms of anxiety and use of psychotropic medication within one and three years
| . | OR (95% CI)i . | HR (95% CI)ii . |
|---|---|---|
| Anxiety | ||
| HADS-A ≥8 | 2.47 (2.25–2.72) | 1.92 (1.80–2.04) |
| HADS-A <8 | 1.00 (reference) | 1.00 (reference) |
| . | OR (95% CI)i . | HR (95% CI)ii . |
|---|---|---|
| Anxiety | ||
| HADS-A ≥8 | 2.47 (2.25–2.72) | 1.92 (1.80–2.04) |
| HADS-A <8 | 1.00 (reference) | 1.00 (reference) |
iMultiple logistic regression analysis adjusted for age, sex, TU, educational level, cohabitation status, diagnosis, smoking status, BMI iiCox regression analysis adjusted for age, sex, TU, educational level, cohabitation status, diagnosis, smoking status, BMI.
Type of funding source: Foundation. Main funding source(s): Novo Nordisk Foundation
