The current study builds on previous research demonstrating a link between anxiety and in-hospital recurrent ischemic and arrhythmic events, by examining the effects of persistent anxiety on recurrent events one year later. Nine hundred and thirteen unstable angina (UA) and myocardial infarction (MI) patients from 12 coronary care units were recruited, and follow-up data was collected at 6 and 12 months post-event. Measures included cardiac symptomatology, healthcare utilization, the PRIME-MD anxiety subscale, the Crown-Crisp Middlesex Hospital Questionnaire phobic anxiety subscale, and the Beck Depression Inventory. Hierarchical logistic regression was used to predict self-reported recurrent cardiac events based on persistent anxiety symptomatology, after controlling for sociodemograhic and medical variables. Over one-third of UA and MI participants experienced elevated anxiety at the time of the ischemic event, symptoms which are understandable in the face of a frightening and life-threatening situation. However, these symptoms persisted for one year in 50% of anxious participants. Although, participants with anxiety reported more atypical cardiac symptomatology, the prevalence of typical cardiac symptoms such as chest pain did not differ based on anxiety. Moreover, contrary to previous findings, anxiety did not result in greater healthcare utilization. After controlling for severity of coronary event, family income, sex, diabetes, and smoking, the following variables were significantly predictive of self-reported recurrent cardiac events at six months or one year: older age, family history of CVD, greater depressive symptomatology at baseline, and anxiety at six months. Only 38% of anxious patients were asked about such symptoms, indicating under-utilization of effective psychotherapeutic treatment.

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