Fang XY, et al. - Researchers sought to determine the effect of generalized anxiety disorder (GAD) on prehospital delay during an acute myocardial infarction (AMI) and delay related cognition and behavior. They found an independent association of GAD with less prehospital delay in AMI patients, however, GAD led to an impaired psychological state in these patients.

• Researchers used data from the cross-sectional Munich examination of delay in patients experiencing acute myocardial infarction (MEDEA) study, with a total of 619 ST-elevated myocardial infarction (STEMI) patients.
• They gathered data on socio-demographic, clinical and psycho-behavioral characteristics at bedside.
• They used the Generalized Anxiety Disorder scale (GAD-7) to assess the outcome.
• A GAD-7 score greater than or equal to 10 indicates general anxiety disorder.

• GAD was detected in a total of 11.47% (n = 71) MI patients.
• Researchers found that GAD was associated with decreased odds of delay compared to patients without GAD (OR 0.58, 95% CI 0.35–0.96), which was more significant in women (112 vs. 238 min, p=0.02) than in men (150 vs. 198 min, p=0.38).
• They also noted that GAD was highly correlated with acute anxiety (p=0.004) and fear of death (p=0.005).
• Nevertheless, after controlling for these 2 covariates, the impact remained significant.
• In addition, a higher cardiovascular risk was more likely to be perceived by GAD patients (OR 2.56, 95% CI 1.37–4.76) in 6 months before MI, which resulted in higher likelihood of making self-decision to go to the hospital (OR 2.68, 95% CI 1.48–4.85) in the acute phase.
• However, data revealed that GAD was also highly related to impaired psychological well-being, stress and fatigue (p < 0.0001).