Fear of death in acute coronary syndromes – incidence and predictors

Introduction
Fear of death is one of the symptoms of acute coronary syndrome (ACS). However, no large data describing the incidence and predictors to the occurrence of fear of death have been published so far.

Aim of the research
To investigate the prevalence of fear of death in patients with ACS as well as factors influencing its occurrence.

Material and methods
The sample consisted of 72 patients aged 38 to 92 years, who were hospitalised for ACS and treated with percutaneous coronary interventions (PCI) in an interventional cardiology centre. We used a dedicated, self-prepared, non-standardised questionnaire. Fear of death was defined as the simultaneous occurrence of a patient’s fear and the thought of possible death.

Results
Fear of death was present in 25% of all enrolled patients. The independent predictors of fear of death occurrence in ACS were: severe or very severe pain (OR = 4.79; 95% CI: 1.44–15.95; p = 0.011) and dyspnoea (OR = 4.98; 95% CI: 1.19–20.02; p = 0.027). There were no statistically significant differences in the occurrence of fear of death in pre-specified subgroups: gender, age, body mass index, co-morbidities, prior myocardial infarction, prior hospital stays, and presence of social support.

Conclusions
The majority of patients with ACS do not feel fear of death while hospitalised for interventional cardiology procedures. The incidence of fear of death may be influenced by the intensity of pain and presence of additional symptoms like dyspnoea.