Panic disorder and incident coronary heart disease: a systematic review and meta-regression in 1 131 612 persons and 58 111 cardiac events

Simple item page
dc.contributor.authorTully, P.
dc.contributor.authorTurnbull, D.
dc.contributor.authorBeltrame, J.
dc.contributor.authorHorowitz, J.
dc.contributor.authorCosh, S.
dc.contributor.authorBaumeister, H.
dc.contributor.authorWittert, G.
dc.date.issued2015
dc.description.abstractBackground: Substantial healthcare resources are devoted to panic disorder (PD) and coronary heart disease (CHD); however, the association between these conditions remains controversial. Our objective was to conduct a systematic review of studies assessing the association between PD, related syndromes, and incident CHD. Method: Relevant studies were retrieved from Medline, EMBASE, SCOPUS and PsycINFO without restrictions from inception to January 2015 supplemented with hand-searching. We included studies that reported hazard ratios (HR) or sufficient data to calculate the risk ratio and 95% confidence interval (CI) which were pooled using a random-effects model. Studies utilizing self-reported CHD were ineligible. Twelve studies were included comprising 1 131 612 persons and 58 111 incident CHD cases. Results: PD was associated with the primary incident CHD endpoint [adjusted HR (aHR) 1.47, 95% CI 1.24–1.74, p < 0.00001] even after excluding angina (aHR 1.49, 95% CI 1.22–1.81, p < 0.00001). High to moderate quality evidence suggested an association with incident major adverse cardiac events (MACE; aHR 1.40, 95% CI 1.16–1.69, p = 0.0004) and myocardial infarction (aHR 1.36, 95% CI 1.12–1.66, p = 0.002). The risk for CHD was significant after excluding depression (aHR 1.64, 95% CI 1.45–1.85) and after depression adjustment (aHR 1.38, 95% CI 1.03–1.87). Age, sex, length of follow-up, socioeconomic status and diabetes were sources of heterogeneity in the primary endpoint. Conclusions: Meta-analysis showed that PD was independently associated with incident CHD, myocardial infarction and MACE; however, reverse causality cannot be ruled out and there was evidence of heterogeneity.
dc.description.statementofresponsibilityP. J. Tully, D. A. Turnbull, J. Beltrame, J. Horowitz, S. Cosh, H. Baumeister and G. A. Wittert
dc.identifier.citationPsychological Medicine, 2015; 45(14):2909-2920
dc.identifier.doi10.1017/S0033291715000963
dc.identifier.issn0033-2917
dc.identifier.issn1469-8978
dc.identifier.orcidTully, P. [0000-0003-2807-1313]
dc.identifier.orcidTurnbull, D. [0000-0002-7116-7073]
dc.identifier.orcidBeltrame, J. [0000-0002-4294-6510]
dc.identifier.orcidHorowitz, J. [0000-0001-6883-0703]
dc.identifier.orcidCosh, S. [0000-0002-8003-3704]
dc.identifier.orcidWittert, G. [0000-0001-6818-6065]
dc.identifier.urihttp://hdl.handle.net/2440/99842
dc.language.isoen
dc.publisherCambridge University Press
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1053578
dc.rightsCopyright © Cambridge University Press 2015
dc.source.urihttps://doi.org/10.1017/s0033291715000963
dc.subjectAetiology
dc.subjectanxiety disorder
dc.subjectanxiety neurosis
dc.subjectcoronary heart disease
dc.subjectmeta-analysis
dc.subjectmyocardial infarction
dc.subjectpanic attack
dc.subjectpanic disorder
dc.subjectsystematic review
dc.titlePanic disorder and incident coronary heart disease: a systematic review and meta-regression in 1 131 612 persons and 58 111 cardiac events
dc.typeJournal article
pubs.publication-statusPublished

Files

Collections

Medicine publications