A five-country comparison of anxiety early after acute myocardial infarction

Abstract

BACKGROUND: Anxiety is common after acute myocardial infarction (AMI) and has the potential to negatively affect physical and psychosocial recovery. There have been no cross-cultural comparisons of anxiety among AMI patients. AIMS: To evaluate whether anxiety after AMI differs across five diverse countries and to determine whether an interaction between country, and sociodemographic and clinical variables contributes to variations in reporting anxiety. METHODS AND RESULTS: A total of 912 individuals with confirmed AMI were enrolled in this prospective, comparative, cross-cultural study. Anxiety was assessed within 72 h of hospital admission using the Brief Symptom Inventory. The mean level of anxiety in the entire sample was 0.62+/-0.76, which is 44% higher than the normal mean level. Anxiety levels were not significantly different among the countries with the exception that patients in England reported lower levels of anxiety than those in the US (P=0.03). However, this difference disappeared after controlling for sociodemographic variables on which the countries differed. CONCLUSION: Patients from each country studied experienced high anxiety after AMI. Even though various cultures were represented in this study, culture itself did not account for variations in anxiety after AMI. It appears that anxiety after AMI is a universal phenomenon.