Department of Heart Disease, University Hospital of North Norway, Sykehusvegen 38, Tromsø 9013, Norway.
Cardiovascular Research Group, Institute of Clinical Medicine, University of Tromsø-The Arctic University of Norway, Hansine Hansens veg 18, Tromsø 9019, Norway.
Eur Heart J Qual Care Clin Outcomes. 2018 Apr 1;4(2):106-112. doi: 10.1093/ehjqcco/qcx039.
Coronary angiography is the gold standard diagnostic test for coronary artery disease (CAD), and the diagnostic results can have an immediate effect on symptoms. The aim of this study was to explore the long-term impact of diagnostic angiography on symptoms of anxiety and depression in a group of patients without previous CAD.
The prospective cohort study included 459 consecutive patients undergoing invasive angiography and was approved by the regional board of ethics. Data were collected at baseline and after 6 and 12 months using self-reports. Symptoms of anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS). The sample population had a mean age of 62 years and included 197 (43%) women. Fifty-three percent had hypertension, and 17% had diabetes. The diagnostic results indicated that 41% of patients had normal vessels; 21% had wall changes; and 38% had obstructive stenosis. No significant difference was found between the diagnostic groups at baseline regarding the levels of anxiety or depression. After 6 months, participants with obstructive stenosis had significantly lower levels of anxiety than those without obstructive stenosis. Improvements were observed in all groups over time in both HADS subscale scores; the largest improvement occurred in patients with obstructive stenosis.
This study demonstrates that patients with normal coronary arteries or minimal coronary disease/non-obstructive coronary disease do not seem to obtain the same benefit from the receipt of information about their coronary status in terms of anxiety and depression as patients with significant obstructive stenosis.
冠状动脉造影是冠心病（CAD）的金标准诊断测试，其诊断结果可立即影响症状。本研究旨在探讨诊断性血管造影对一组无既往 CAD 病史患者的焦虑和抑郁症状的长期影响。
这项前瞻性队列研究纳入了 459 例接受有创血管造影的连续患者，该研究得到了地区伦理委员会的批准。数据在基线时、6 个月和 12 个月时通过自我报告收集。使用医院焦虑和抑郁量表（HADS）测量焦虑和抑郁症状。样本人群的平均年龄为 62 岁，包括 197 名（43%）女性。53%患有高血压，17%患有糖尿病。诊断结果表明，41%的患者血管正常；21%有管壁改变；38%有阻塞性狭窄。在基线时，不同诊断组之间的焦虑或抑郁水平没有显著差异。6 个月后，与无阻塞性狭窄的患者相比，有阻塞性狭窄的患者焦虑水平显著降低。所有组的 HADS 亚量表评分随时间均有改善；阻塞性狭窄患者的改善最大。
本研究表明，与有明显阻塞性狭窄的患者相比，冠状动脉正常或有最小冠状动脉疾病/非阻塞性冠状动脉疾病的患者，在获得有关其冠状动脉状况的信息后，在焦虑和抑郁方面似乎并未获得同样的益处。
