Background: Prehospital delay in seeking treatment in patients with acute myocardial infarction(AMI)is a vital factor on patients outcome.However,most studies focus on demographic factors,clinical symptoms and display of AMI,and cognitive aspects,and there is a lack of systematic research on social-psychological factors.As a common psychological factor,anxiety and its effects over AMI patient's prehospital time(PHT)has not yet been reported.Objective: Our study was to assess the impact of anxiety on PHT of AMI patients in order to provide a basis for the development of prehospital delay intervention strategies for anxiety-related AMI patients.Methods: In this multi-centered,cross-sectional observational study,we enrolled 265 patients diagnosed with AMI from four hospitals(Tongji Hospital of Tongji University,Tenth People's Hospital of Tongji University,Yangpu Hospital Tongji University,People's Liberation Army No.411 Hospital)in Shanghai from April 2016 to February 2017.Data collection included demographic status,symptoms of AMI onset,decision time,transit time,PHT(the time of symptom onset to the arrival at hospital door).Anxiety was measured with the Generalized Anxiety Disorder-7(GAD-7).Results: The mean PHT of 265 patients was 150.0(70.0,501.0)min.The results of anxiety assessment showed that a total of 104 patients displayed symptoms of anxiety(mild,n=81; moderate,n=16; severe,n=7).We found that patients with anxiety were more likely to display sign of depression,cardiac denial and fear of death(P<0.05).The incidence of feeling of death and dizziness in anxious patients was higher than non-anxious patients(P<0.05).There was no significant difference in decision time,transit time and PHT between anxious and non-anxious patients(P>0.05).PHT and decision time in patients with severe anxiety tended to be longer than those with mild anxiety(P<0.05).There was no significant difference in the transit time of patients with different degrees of anxiety(P>0.05).Conclusion: Patients with AMI and anxiety are more likely to have depression and cardiac denial.In comparison to patients who are mildly anxious,severely anxious patients with AMI might significantly prolong decision time and PHT,which is more likely to cause the miss of the optimal reperfusion period and affect the prognosis.