A Medical Device Daily

Research published in the European Society of Cardiology's (ESC; Sophia Antipolis, France) European Heart Journal indicates that people who have been diagnosed with panic attacks or panic disorder have a greater risk of subsequently developing heart disease or suffering a heart attack than the normal population, with higher rates occurring in younger people.

The study found that people who were younger than 50 when first diagnosed had a significantly higher risk of subsequent myocardial infarctions (MI), but this was not the case in older people. It also found there was a significantly higher incidence of subsequent coronary heart disease (CHD) in people diagnosed with panic attacks/disorder at all ages, but this was more marked in the under 50s.

The research also showed that the risk of dying from CHD was actually reduced among people of all ages who had been diagnosed with panic attacks/disorder.

The study is the first to look at a large sample of the UK population of all ages (a total of 404,654 people) selected from a primary care population that the researchers said could be broadly generalized to other countries with a similar socio-demographic structure.

It also is the first study to identify that the higher risk of heart attacks with panic attacks/disorder is mainly in younger people (aged under 50 years), and that having a panic attacks/disorder diagnosis is associated with a lower risk of dying from heart conditions.

Dr. Kate Walters, a senior lecturer in primary care at University College London, who led the research, said, "Not much is known about the relationship between panic disorder and cardiac disease. The symptoms of panic attacks can closely mimic those of a heart attack or acute cardiac disease, and it seems that there may be a complex relationship between them."

She added, "Our findings have significant implications for clinicians. Panic attacks were associated with a significant increased risk of a subsequent diagnosis of CHD and acute MI in those ... younger than 50. This may be due to initial misdiagnosis of CHD as panic attacks, or a true underlying increased risk of CHD with panic attacks."

Walters said, "Clinicians should be vigilant for this possibility when diagnosing and treating people presenting with symptoms of panic."

She and her colleagues looked at primary care medical records for 57,615 adults diagnosed with panic attacks/disorder and 347,039 adults who did not have the condition. They found that those under 50 were more than a third as likely (38%) to have a heart attack and nearly half as likely (44%) to develop heart disease subsequently than people who had not been diagnosed with the condition. For people over 50, there was a slightly increased risk of heart disease (11%).

When the researchers looked at deaths among adults diagnosed with panic attacks/disorder, they found that for all ages the risk of death from heart disease was reduced by about a quarter (24%) compared with the normal population.

"This might be because the higher risk of coronary heart disease and heart attacks occurred [among] younger people who have fewer heart-related deaths generally," said Walters, "or it might be because people with panic disorders go to their doctors earlier and more frequently and, therefore, are more likely to have their heart disease identified and treated early, thus reducing the likelihood of dying from it."

She added, "Although we made adjustments for identified depression, it is possible that some patients with panic might have had undiagnosed depression, which is also associated with an increased risk of CHD."

AdvaMed's Ubl applauds German action

Stephen Ubl, president/CEO of the Advanced Medical Technology Association (AdvaMed; Washington), hailed the German government's passage of the Hospital Financing Reform Act (Medical Device Daily; Dec. 23, 2008).

Ubl noted that previously, patients often would have to wait up to a year to benefit from a positive decision from the German Institute for Hospital Reimbursement (Institut f r das Entgeltsystem im Krankenhaus, or InEK) on new therapies because hospitals could only submit the application for reimbursement at the end of their budget negotiations – which often took close to a year to complete.

"This important amendment to the Innovation Clause (section 6 of the Hospital Reimbursement Act) will now allow hospitals the right to request reimbursement for innovative technologies in an expedited manner," he said. "Hospitals may now apply for approved innovative products earlier in the year and independent of their yearly overall budget expenditures."

Ubl said the vote is "an important step toward a more efficient access to healthcare that will benefit German patients. We commend the German parliament for improving patient access to life-saving, life-enhancing medical innovations."

First GP health center in the East Midlands

The first fully operational new general practitioner (GP) health center in the East Midlands region of the UK has been opened in Corby, Northamptonshire.

The Lakeside Plus center is the first of four new GP health centers set to open across Northamptonshire and 12 across the East Midlands, providing residents with additional GP services tailored to their needs. The centers, which will see patients from 8 a.m. to 8 p.m., seven days a week, are part of a government program to increase access to family doctor services.

The region also will benefit from six new and additional GP practices in its most poorly served area as part of the same initiative.

Health Minister Phil Hope said the new center would improve access to healthcare for local people. "Patients tell me that they want to be able to see a GP at times convenient to them, so this center will offer them the greater choice and flexibility they want."