(P108) ASSESSMENT OF TWO COMMON QUANTITATIVE PSYCHOMETRIC TOOLS FOR IDENTIFICATION OF ANXIETY IN PATIENTS WITH ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: Anxiety is a widely prevalent condition, with higher reported rates in those with chronic health issues, and is associated with poorer long-term outcomes. Chronic cardiovascular conditions such as atrial fibrillation (AF) can be associated with psychological distress, however there is a paucity of data on quantified levels of anxiety in this population. The aim of this systematic review and meta-analysis was to compare anxiety levels using the Spielberger State-Trait Anxiety Inventory (STAI) and Zung’s Self-Rating Anxiety Scale (Zung’s SAS) in patients with AF compared to control populations. We hypothesise that patients with AF demonstrate higher levels of anxiety when compared to healthy populations.

METHODS AND RESULTS: A systematic literature search of medical databases (CINAHL, PubMED, Ovid Medline, EMBASE, Web of Science, SCOPUS, ProQuest, Science Direct and the Cochrane Central Register of Controlled Trials from 2000 to 2022) and grey literature was performed using PRISMA principles to identify all relevant studies. Measures of anxiety as defined by the STAI-State and Trait and by Zung SAS scores were meta-analysed using a random-effects model for overall effect size measured as the standardised mean difference (SMD). Data from 5 studies using STAI were pooled i.e. STAI-State (n=327 AF patients) and STAI-Trait (n=171 AF patients) and compared to published control values (Donzuso et al 2014). Likewise, 3 studies using Zung’s SAS (n=209 AF patients) were compared with published control values (Dunstan et al 2020). Patients with AF demonstrated statistically significant higher STAI-State (SMD 1.26; CI: 0.65–1.88, p< 0.001) and STAI-Trait (SMD 0.54; CI:0.11-0.97, p=0.01) scores. Likewise, patients with AF demonstrated statistically significant higher Zung’s SAS scores (SMD 2.12; CI:1.83-2.40, p< 0.001). See Figure.

Conclusion: Patients with AF demonstrated higher STAI and Zung’s SAS scores compared to published control values, suggesting elevated levels of anxiety in these patients. This body of evidence supports the utility of the STAI and Zung’s SAS tools to quantify levels of anxiety in patients with AF in a clinical setting, which may allow for targeted intervention and psychosocial support for these patients.