Methods: The Integrated Health Care Information Services (IHCIS) managed care database is a fully de-identified, HIPAA-compliant database and includes complete medical history for more than 17 million managed care lives; data from more than 30 U.S. health plans covering 7 census regions; and patient demographics, including morbidity, age and gender. A total of 39,920 PD patients and an equal number of patients without PD were included in this cohort study. The Cox proportional hazards regression models were used to assess the risk of CHD adjusted for age at entry into the cohort, tobacco use, obesity, depression and use of medications including angiotensin converting enzyme (ACE) inhibitors, beta blockers and statins.

Results: Patients with PD were observed to have nearly a two-fold increased risk for CHD (HR=1.87, 95% CI=1.80-1.91) after adjusting for these factors. There was some evidence of a possible trend toward increased risk in a subgroup of patients diagnosed with depression. After controlling for the aforementioned covariates and comparing these patients to those without a diagnosis of depression, it was noted that patients with a comorbid diagnosis of depression were almost 3 times more likely to develop CHD (HR=2.60, 95% CI = 2.30- 3.01).

Conclusions: The risk of CHD associated with a diagnosis of PD suggests the need for cardiologists and internists to monitor panic disorder in order to ensure a reduction in the risk of CHD.