Association between anxiety state and mitral valve disorders: A Taiwanese population-wide observational study Navneet Kumar Dubey a,1 , Shabbir Syed-Abdul b,1 , Phung Anh Nguyen b , Rajni Dubey c , Usman Iqbal b , Yu-Chuan Li b , Wei-Hong Chen d , Win-Ping Deng a,d,e, * a Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering,Taipei Medical University, Taipei, Taiwan b Graduate Institute of Biomedical Informatics, College of Medical Science and Technology,Taipei Medical University, Taipei, Taiwan c Freelance Writer, Taipei, Taiwan d Stem Cell Research Center, Taipei Medical University, Taipei, Taiwan e Graduate Institute of Basic Medicine, Fu-Jen Catholic University,Taipei,Taiwan ARTICLE INFO Article history: Received 4 December 2015 Received in revised form 11 April 2016 Accepted 15 April 2016 ABSTRACT Background and objective: Despite substantial research progress in concurrent diseases, for instance comorbidities involving anxiety state (AS) and mitral valve disorders (MVD), the current measures and care are limited and no consensus about their association has yet been reached. Hence, this study aims to analyze the prevalence and association between AS and MVD among Taiwanese population. Methods: We employed phenome-wide association study (PWAS) portal to investigate the association between AS and MVD using claim data of Taiwan’s National Health Insurance Research Database (NHIRD) from year 2000 to 2002. Association strength between AS and MVD was analyzed among overall age and gender groups. Results: We found an overall stronger association between AS and MVD, which was signifi- cantly higher in younger age group (OR 15, 95% CI 14.82–16.88) than in the elderly age group (OR 1.99, 95% CI 1.76–2.24). Also, the study reveals a higher incidence of co-occurrence in females than males, particularly in age group of 40–49. Conclusions: Based on our results showing considerable strength of association between AS and MVD, this study suggests the necessity of MVD assessment in all patients with AS, par- ticularly in younger females. Moreover, we also propose psychotherapeutic as well as pharmacologic intervention for comorbidity-based pathologies to better the quality care for high-need Taiwanese population. © 2016 Elsevier Ireland Ltd. All rights reserved. Keywords: Anxiety Mitral valve disorders Comorbidity * Corresponding author. Stem Cell Research Center, Graduate Institute of Biomedical Materials and Tissue Engineering,Taipei Medical University, 250 Wuxing Street, Taipei, Taiwan 11031 and Fu-Jen Catholic University, Taipei, Taiwan. Tel.: +886 2 27361661 ext.7169; fax: +886 2 2739 5584. E-mail address: wpdeng@tmu.edu.tw (W.-P. Deng). 1 These two authors have equally contributed to this work. http://dx.doi.org/10.1016/j.cmpb.2016.04.018 0169-2607/© 2016 Elsevier Ireland Ltd. All rights reserved. computer methods and programs in biomedicine 132 (2016) 57–61 journal homepage: www.intl.elsevierhealth.com/journals/cmpb