Anxiolytic medication use is not associated with anxiety level and does not reduce complications after acute myocardial infarction.
Anxiolytic medication use is not associated with anxiety level and does not reduce complications after acute myocardial infarction.
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抗焦虑药物的使用与焦虑水平无关，并且不会减少急性心肌梗塞后的并发症。
DOI：
10.1111/jocn.12064
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发表时间：
2013
影响因子：
4.2
通讯作者：
Moser,DebraK
中科院分区：
文献类型：
--
作者：
Abed,MonaA;Frazier,Susan;Hall,LynneA;Moser,DebraK
目的和目的探讨急性心肌梗死（AMI）后患者焦虑水平和抗焦虑药物使用与院内并发症的关系。背景：关于抗焦虑药物对急性心肌梗死患者的保护作用，有相互矛盾的数据。检查抗焦虑药物和焦虑水平的相互作用可以解释这些不同的结果。设计：本研究是对一项多地点前瞻性研究的现有数据进行的二次分析，该研究旨在探讨焦虑对AMI患者院内并发症的影响。方法患者主要为男性，高加索人，Killip 1或2级，来自美国和澳大利亚（n= 156）。急诊科和重症监护病房的焦虑水平和院内并发症采用自我报告方法和医疗记录回顾收集。在控制了人口统计学和临床协变量后，Logistic回归分析检验了抗焦虑药物的使用是否会影响焦虑与院内并发症之间的关系。结果在ED中，31%的参与者非常焦虑或极度焦虑；只有5%的人服用抗焦虑药物。在重症监护病房，近一半的参与者接受了抗焦虑药物治疗。焦虑水平与抗焦虑药物的使用没有关联。焦虑是院内并发症发生概率的独立预测因子。抗焦虑药物的使用并未改变焦虑与院内并发症之间的关系。结论AMI患者使用抗焦虑药物与焦虑水平无关，也不会降低院内并发症的发生概率。与临床实践的相关性临床医生需要定期评估焦虑并适当治疗。定期的焦虑评估可以促进抗焦虑药物的适当使用。急性心肌梗死患者治疗的临床指南应涉及焦虑评估和适当使用抗焦虑药物以改善患者预后。
Aims and objectivesTo examine the association of anxiety level and anxiolytic medication use with in‐hospital complications in patients following acute myocardial infarction (AMI).BackgroundThere are conflicting data about the protective effect of anxiolytic medication used in patients after acute myocardial infarction. Examination of the interaction of anxiolytic medication and anxiety level may explain these disparate results.DesignThis was a secondary analysis of existing data from a multisite, prospective study of the impact of anxiety on in‐hospital complications in patients with AMI.MethodsPatients were primarily men, Caucasians, with Killip class 1 or 2, from the USA and Australia (n= 156). Anxiety level in the emergency department and intensive care unit and in‐hospital complications were collected using self‐report measures and medical record review. Logistic regression analyses examined whether the use of anxiolytic medication influenced the relationship between anxiety and in‐hospital complications after controlling for demographic and clinical covariates.ResultsIn the ED, 31% of participants were very or extremely anxious; anxiolytic medication was given to only 5%. In the intensive care unit, nearly half of participants received anxiolytic medication. There was no association between anxiety level and use of anxiolytic medication. Anxiety was an independent predictor of the probability of in‐hospital complications. The administration of anxiolytic medication did not alter the relationship between anxiety and in‐hospital complications.ConclusionUse of anxiolytics in patients with AMI was not associated with anxiety level and did not reduce the probability of in‐hospital complications.Relevance to clinical practiceClinicians need to regularly assess anxiety and treat it appropriately. Regular anxiety assessment may promote appropriate use of anxiolytic medication. Clinical guidelines for the management of patients with an AMI should address anxiety assessment and appropriate use of anxiolytic medication to improve patients' outcomes.
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