Tatishvili S, Sinitsa M, Jorbendaze R, Kavtaradze G
Department of Internal Medicine №3,Tbilisi State Medical University, Emergency Cardiology Center, Tbilisi Georgia.
Georgian Med News. 2016 Sep(258):23-27.
Severe infarction or its consequences are considered as triggering factors of incidental depression. The aim of our study was to reveal factors associated with depressive episode in patients hospitalized with acute coronary syndrome (acute myocardial infarction, unstable angina). The Beck Depression inventory (BDI) was used for assessment of depressive symptoms in patients with coronary disease in Emergency Cardiology Clinic Tbilisi, Georgia. The study sample included 84 patients. The clinical Information was collected from hospital recordings. The chi-square test was used for assessment the difference between groups. Independent t-test was used to compare means for numerical variable "age". A binary logistic regression was applied in order to assess a relationship between disease severity factors (ejection fraction and revascularization) and depressive episode. Study sample included 79% of men and 21% of women with a mean age 59 years. Coronary obstruction as well as cardiac risk factors was revealed in majority of participants. The mean depression score was 13.0, while BDI score > 16 was revealed in 28.6% of patients. In the binary regression model ejection fraction was inversely associated with depressive episode even after adjustment to the age, gender and coronary risk factors. When disease severity markers (ejection fraction, revascularization) together with classic risk factors were included into the model, they explained only 42% of depressive episodes. It may be concluded that disease severity markers together with classic cardiac risk factors explain only partially depressive episode in patients, hospitalized for acute coronary events. A multidisciplinary approach is needed in order to provide optimal care and improve prognosis of patients with acute coronary syndrome (ACS).
严重梗死或其后果被视为偶发性抑郁症的触发因素。我们研究的目的是揭示急性冠状动脉综合征（急性心肌梗死、不稳定型心绞痛）住院患者中与抑郁发作相关的因素。在格鲁吉亚第比利斯急诊心脏病诊所，使用贝克抑郁量表（BDI）评估冠心病患者的抑郁症状。研究样本包括84名患者。临床信息从医院记录中收集。采用卡方检验评估组间差异。使用独立t检验比较数值变量“年龄”的均值。应用二元逻辑回归评估疾病严重程度因素（射血分数和血运重建）与抑郁发作之间的关系。研究样本包括79%的男性和21%的女性，平均年龄59岁。大多数参与者都存在冠状动脉阻塞以及心脏危险因素。平均抑郁评分为13.0，而28.6%的患者BDI评分>16。在二元回归模型中，即使在调整年龄、性别和冠状动脉危险因素后，射血分数仍与抑郁发作呈负相关。当将疾病严重程度指标（射血分数、血运重建）与经典危险因素纳入模型时，它们仅能解释42%的抑郁发作情况。可以得出结论，疾病严重程度指标与经典心脏危险因素仅能部分解释急性冠状动脉事件住院患者的抑郁发作情况。为了提供最佳护理并改善急性冠状动脉综合征（ACS）患者的预后，需要采取多学科方法。
