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https://hdl.handle.net/2440/99842
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Type: | Journal article |
Title: | Panic disorder and incident coronary heart disease: a systematic review and meta-regression in 1 131 612 persons and 58 111 cardiac events |
Author: | Tully, P. Turnbull, D. Beltrame, J. Horowitz, J. Cosh, S. Baumeister, H. Wittert, G. |
Citation: | Psychological Medicine, 2015; 45(14):2909-2920 |
Publisher: | Cambridge University Press |
Issue Date: | 2015 |
ISSN: | 0033-2917 1469-8978 |
Statement of Responsibility: | P. J. Tully, D. A. Turnbull, J. Beltrame, J. Horowitz, S. Cosh, H. Baumeister and G. A. Wittert |
Abstract: | Background: 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. |
Keywords: | Aetiology anxiety disorder anxiety neurosis coronary heart disease meta-analysis myocardial infarction panic attack panic disorder systematic review |
Rights: | Copyright © Cambridge University Press 2015 |
DOI: | 10.1017/S0033291715000963 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1053578 |
Published version: | http://dx.doi.org/10.1017/s0033291715000963 |
Appears in Collections: | Aurora harvest 7 Medicine publications |
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