Table 1.
Summary of included studies.
| References | Study design, sample n | Anxiety or mental stress measure | Findings | |
|---|---|---|---|---|
| Type I | Li et al. (17) | Retrospective cohort with propensity score matching, n = 26,204 | Pre-existing anxiety disorders | The incidence of in-hospital SCA was lower in the anxiety group than in the non-anxiety group of MI patients. This protective effect was only found in patients with non-ST segment elevation MI. |
| Habibović et al. (18) | Prospective cohort, n = 1,012 | STAI-S at time of ICD implantation | Anxiety increased the incidence of aborted SCD over 1-year follow-up. The associations remained significant after adjustment for multiple variables and were similar for men and women. | |
| Watkins et al. (19) | Prospective cohort, n = 947 | CCEI phobic anxiety subscale | Overall, there was no association between anxiety and SCD. In women, however, anxiety increased the risk of SCD. | |
| Albert et al. (20) | Prospective cohort, n = 71,162 | CCEI phobic anxiety subscale | Anxiety increased the risk of SCD in a sample of healthy women over a 32-year follow-up. The associations remained significant after adjustment for multiple variables but were attenuated after further adjustment for various comorbidities. | |
| Frasure-Smith et al. (21) | Prospective cohort, n = 222 | STAI-S at time of post-MI hospital admission | Anxiety was not significantly associated with incident fatal or non-fatal SCA in the first year post-MI. | |
| Kawachi et al. (22) | Case-control in a prospective cohort, n = 1,895 | Anxiety symptom scale out of 5 questions from the CMI | Anxiety increased the risk of SCD in a sample of healthy men over a 12-year follow-up, also after adjustment for several variables. | |
| Kawachi et al. (23) | Prospective cohort, n = 33,858 | CCEI phobic anxiety subscale | Anxiety increased the risk of SCD in a sample of healthy men over a 2-year follow-up, also after adjustment for several variables. | |
| Type II | Marijon et al. (24) | Cross-sectional database | Paris COVID-19 lockdown vs. control period | During the Paris lockdown, the maximal weekly SCA incidence was significantly higher than during control periods, and a rapid return to normal was seen in the final weeks. |
| Simon et al. (25) | Cross-sectional database | Football tournaments (2012, 2016, 2018) vs. control periods. | There was no increased SCA incidence during the (combined) football tournament periods vs. control periods in Polish men. | |
| Niiyama et al. (26) | Cross-sectional database | Great East Japan earthquake and tsunami 2011 vs. control periods | For the initial 4 weeks after the earthquake, the incidence of SCD in the Iwate prefecture was doubled as compared with control periods, after which it returned to baseline. | |
| Niederseer et al. (27) | Cross-sectional database | Football tournament days the German team played (2006) vs. control periods | There was no increased incidence of SCA hospital admissions during the football tournament vs. control periods in men and women in the German province of Bavaria. | |
| Aoki et al. (28) | Cross-sectional database | Great East Japan earthquake 2011 vs. control periods | The number of SCA ambulance transports was significantly increased in the week following the earthquake as compared with control periods; it peaked on day 2 followed by a gradual decline. | |
| Gold et al. (29) | Cross-sectional database | Nisqually earthquake 2001 and 9-11 terrorist attack 2001 (USA) vs. control periods | The incidence of SCD increased during the 48 h following the Nisqually earthquake, as compared with control periods. No increased SCD incidence was found during 1-week post-earthquake, nor during 48-h or 1 week after the 9-11 terrorist attack. | |
| Katz et al. (30) | Cross-sectional database | FIFA Football World Cup 2002 vs. control period | The incidence of SCD increased during the FIFA in both men and women. | |
| Leor et al. (31) | Cross-sectional database | Northridge (USA) earthquake 1994 vs. control periods | The incidence of SCD increased on the day of the Northridge earthquake as compared with control periods and afterwards returned to baseline level. | |
| Type III | Chang Liu et al. (32) | Case-control, n = 72 | LCUs over 1 year before SCA, based on the SRSS, SSS, or RLCQ | SCA survivors did not significantly differ from matched controls with respect to stressful life events during the year before the SCA. |
| Jeong et al. (33) | Case-control, n = 190 | Major life events in 1 year before SCA or control periods based on family | SCA survivors had a higher number of major life events than matched controls. | |
| Wicks et al. (34) | Case- crossover, n = 490 | Major life events in 1 vs. 2–6 months before SCA, based on spouse interviews. | Major life events occurred more frequently during the 1 month before the SCA than during the control period. | |
| Cottington et al. (35) | Case-control, n = 162 | Major life events in 6 months before SCD, based on interviews with spouses or next of kin. | SCD cases had experienced a similar number of life events (total, negative, unclassifiable) during 6 months before death as had neighborhood controls, however, they had experienced less positive life events and more often the death of a significant other. | |
| Rahe and Lind (36) | Case- crossover, n = 39 | LCUs over 3 years before SCD based on the Schedule of Recent Events questionnaire by spouses or next of kin. | LCUs were higher in the 6 months before SCD than during the control periods in both healthy subjects and those at risk (CHD history). |
CCEI, Crown-Crisp experiential index; CHD, coronary heart disease; CMI, Cornell Medical index; ICD, implantable cardioverter defibrillator; LCUs, life change units. LVEF, left ventricular ejection fraction; MI, myocardial infarction; SCA, sudden cardiac arrest; SCD, sudden cardiac death; SRRS, Social Readjustment Rating Scale; SSS=Student Stress Scale; STAI-S, state portion of Spielberger's State-Trait Anxiety Inventory; RLCQ, Recent Life Changes Questionnaire.