Tang X, Liu G, Zeng YJ. Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction: A comprehensive review of clinical manifestations and interventions. World J Psychiatry 2025; 15(12): 110290 [PMID: 41357945 DOI: 10.5498/wjp.v15.i12.110290]
Corresponding Author of This Article
Yun-Jie Zeng, MD, Department of Cardiovascular Medicine, The Affiliated Dazu's Hospital of Chongqing Medical University, No. 1073 Second Ring South Road, Tangxiang Street, Dazu District, Chongqing 402360, China. zengyunjie@hospital.cqmu.edu.cn
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Psychiatry
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 19, 2025 (publication date) through Dec 9, 2025
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World Journal of Psychiatry
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2220-3206
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Tang X, Liu G, Zeng YJ. Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction: A comprehensive review of clinical manifestations and interventions. World J Psychiatry 2025; 15(12): 110290 [PMID: 41357945 DOI: 10.5498/wjp.v15.i12.110290]
World J Psychiatry. Dec 19, 2025; 15(12): 110290 Published online Dec 19, 2025. doi: 10.5498/wjp.v15.i12.110290
Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction: A comprehensive review of clinical manifestations and interventions
Xin Tang, Gan Liu, Yun-Jie Zeng
Xin Tang, Department of Cardiovascular Medicine, People's Hospital of Chongqing Hechuan, Chongqing 401520, China
Gan Liu, Department of General Practice, People's Hospital of Chongqing Hechuan, Chongqing 401520, China
Yun-Jie Zeng, Department of Cardiovascular Medicine, The Affiliated Dazu's Hospital of Chongqing Medical University, Chongqing 402360, China
Author contributions: Xin T and Gan L contributed equally to this work and were responsible for the literature search, data extraction, analysis, and manuscript drafting; Zeng YJ supervised the project, provided clinical expertise, and critically revised the manuscript; all the authors approved the final version and agree to be accountable for the work.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Jie Zeng, MD, Department of Cardiovascular Medicine, The Affiliated Dazu's Hospital of Chongqing Medical University, No. 1073 Second Ring South Road, Tangxiang Street, Dazu District, Chongqing 402360, China. zengyunjie@hospital.cqmu.edu.cn
Received: June 27, 2025 Revised: July 30, 2025 Accepted: September 16, 2025 Published online: December 19, 2025 Processing time: 153 Days and 1.6 Hours
Abstract
Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction affect approximately 20%-40% of patients, with a significantly greater prevalence in females (OR = 1.8). These disorders manifest through physiological symptoms, cognitive distortions, behavioral avoidance, and cardiac-specific concerns and typically emerge within 1-2 weeks post-procedure. Key risk factors include female sex, younger age (< 55 years), psychiatric history, procedural complexity, and poor social support. Anxiety negatively affects cardiovascular outcomes when left untreated, leading to higher readmission rates (HR = 1.47) and recurrent cardiovascular events (HR = 1.31), as well as lower medication adherence and quality of life. Screening is optimally conducted 7-10 days post-procedure via validated tools such as the Hospital Anxiety and Depression Scale, Anxiety. Heart-specific cognitive behavioral therapy (SMD = -0.72), selective serotonin reuptake inhibitors (especially sertraline), and integrated cardiac rehabilitation programs that incorporate both psychological and physical elements are among the beneficial interventions that have been supported by evidence. These all-encompassing strategies show long-term improvements in cardiovascular outcomes, functional ability, and healthcare expenses in addition to immediate benefits in lowering anxiety. Digital initiatives have the potential to increase access, especially in underprivileged areas. Early identification of high-risk patients and implementation of timely, targeted interventions represent crucial strategies for improving both psychological and cardiovascular outcomes in this vulnerable population.
Core Tip: Following percutaneous coronary intervention (PCI) for acute myocardial infarction, 20%-40% of patients suffer from anxiety disorders, which have a substantial negative influence on cardiovascular outcomes, medication adherence, and rehabilitation. The molecular mechanisms, sex-specific patterns, clinical manifestations, and temporal trajectories of post-PCI anxiety are highlighted in this review. Additionally, it assesses integrated cardiac rehabilitation programs, pharmaceutical treatments, psychological therapies (particularly cardiac-specific cognitive behavioral therapy), and evidence-based screening instruments. For this susceptible group, a multidisciplinary, individualized strategy that includes timely screening, focused intervention, and long-term follow-up is necessary to enhance both psychological health and cardiovascular prognosis.
