Effects of beta-blockers and anxiety on complication rates after acute myocardial infarction.

摘要

BACKGROUND: Anxiety is common after acute myocardial infarction and increases the number of complications and the length of stay in the hospital. Anxiety-induced activation of the sympathetic nervous system is hypothesized to be an underlying cause of increased complication rates. Little is known about whether use of beta-blockers eliminates the effects of anxiety on complication rate and length of stay. OBJECTIVE: To compare number of complications and length of stay among nonanxious and anxious patients receiving beta-blockers during hospitalization. METHOD: A total of 322 patients with acute myocardial infarction participated in this study within 48 hours of hospital admission. Patients completed the Brief Symptom Inventory to assess anxiety level. After discharge, medical records were reviewed to determine use of beta-blockers, type and number of complications, and length of stay. RESULTS: Most patients (96%) were treated with less than 200 mg daily of metoprolol. Anxious patients had more complications (mean [SD], 1.43 [0.15] vs 0.73 [.09], P