Kala Petr, Hudakova Nela, Jurajda Michal, Kasparek Tomas, Ustohal Libor, Parenica Jiri, Sebo Marek, Holicka Maria, Kanovsky Jan
Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.
Faculty of Medicine, Masaryk University, Brno, Czech Republic.
PLoS One. 2016 Apr 13;11(4):e0152367. doi: 10.1371/journal.pone.0152367. eCollection 2016.
The main objective of the study was to find out prevalence of depression and anxiety symptoms in the population of patients with AMI with ST-segment elevation (STEMI), treated with primary PCI (pPCI). Secondary target indicators included the incidence of sleep disorders and loss of interest in sex.
The project enrolled 79 consecutive patients with the first AMI, aged <80 years (median 61 years, 21.5% of women) with a follow-up period of 12 months. Symptoms of depression or anxiety were measured using the Beck Depression Inventory II tests (BDI-II, cut-off value ≥14) and Self-Rating Anxiety Scale (SAS, cut-off ≥ 45) within 24 hours of pPCI, before the discharge, and in 3, 6 and 12 months). Results with the value p<0.05 were considered as statistically significant. The BDI-II positivity was highest within 24 hours after pPCI (21.5%) with a significant decline prior to the discharge (9.2%), but with a gradual increase in 3, 6 and 12 months (10.4%; 15.4%; 13.8% respectively). The incidence of anxiety showed a relatively similar trend: 8.9% after pPCI, and 4.5%, 10.8% and 6.2% in further follow-up.
Patients with STEMI treated by primary PCI have relatively low overall prevalence of symptoms of depression and anxiety. A significant decrease in mental stress was observed before discharge from the hospital, but in a period of one year after pPCI, prevalence of both symptoms was gradually increasing, which should be given medical attention.
本研究的主要目的是了解接受直接经皮冠状动脉介入治疗（pPCI）的ST段抬高型急性心肌梗死（STEMI）患者群体中抑郁和焦虑症状的患病率。次要目标指标包括睡眠障碍的发生率和对性兴趣丧失。
该项目连续纳入79例首次发生AMI、年龄<80岁（中位年龄61岁，女性占21.5%）的患者，随访期为12个月。在pPCI后24小时内、出院前以及3、6和12个月时，使用贝克抑郁量表II测试（BDI-II，临界值≥14）和自评焦虑量表（SAS，临界值≥45）测量抑郁或焦虑症状。p值<0.05的结果被认为具有统计学意义。BDI-II阳性率在pPCI后24小时内最高（21.5%），出院前显著下降（9.2%），但在3、6和12个月时逐渐上升（分别为10.4%、15.4%、13.8%）。焦虑发生率呈现相对相似的趋势：pPCI后为8.9%，后续随访中分别为4.5%、10.8%和6.2%。
接受直接经皮冠状动脉介入治疗的STEMI患者抑郁和焦虑症状的总体患病率相对较低。在出院前观察到心理压力显著降低，但在pPCI后的一年时间里，两种症状的患病率逐渐上升，应引起医学关注。
