Rawashdeh Sukaina I, Ibdah Rasheed, Kheirallah Khalid A, Al-Kasasbeh Abdullah, Raffee Liqaa A, Alrabadi Nasr, Albustami Iyad S, Haddad Rabia, Ibdah Raed M, Al-Mistarehi Abdel-Hameed
Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Clin Pract Epidemiol Ment Health. 2021 Sep 16;17:103-113. doi: 10.2174/1745017902117010103. eCollection 2021.
Depression and cardiovascular disorders are significant determinants of health that affect the quality of life and life expectations. Despite the high importance of depression screening among Coronary Artery Disease (CAD) patients, the time being to assess and treat it remains controversial.
This study aims to assess the prevalence estimates and severity of depressive symptoms and determine the risk factors associated with developing such symptoms among CAD patients after ten days of Percutaneous Coronary Intervention (PCI).
All patients who underwent elective PCI between October 5, 2019, and Mid-March 2020 and diagnosed with CAD were included in this cross-sectional study. CAD was defined as intra-luminal stenosis of ≥ 50% in one or more of the coronary arteries. Depressive symptoms were screened after ten days of the PCI utilizing the patient health questionnaire-9 (PHQ-9) tool. A linear regression model was used to assess the adjusted effects of independent variables on PHQ-9 scores. Electronic medical records, clinical charts, and PCI and echocardiogram reports were reviewed.
Out of 385 CAD patients, a total of 335 were included in this study, with a response rate of 87%. The participants' mean (±SD) age was 57.5±10.7 years, 75.2% were males, 43% were current smokers, and 73.7% had below bachelor's education. The prevalence estimates of patients with moderate to severe depressive symptoms (PHQ-9 ≥10) was 34%, mild depression 45.1%, and normal 20.9%. Female gender, low educational level and diabetes mellitus were found to be the significant independent predictors of depression among our cohort with (t(333) = 3.68, <0.001); (t(333) = 5.13, <0.001); and (t(333) = 2.79, =0.042), respectively.
This study suggests a high prevalence of depressive symptoms among CAD patients after ten days of PCI. Approximately one out of three patients with CAD have significant symptoms of depression, which is an alarming finding for clinicians. Moreover, this study demonstrates a lack of sufficient depression recognition and management in similar study settings. Integration of mental health assessment and treatment among patients with CAD as soon as after PCI is recommended for optimal and effective treatment and to obtain the best outcomes.
抑郁症和心血管疾病是影响生活质量和预期寿命的重要健康决定因素。尽管在冠状动脉疾病（CAD）患者中进行抑郁症筛查非常重要，但评估和治疗抑郁症的时机仍存在争议。
本研究旨在评估经皮冠状动脉介入治疗（PCI）十天后CAD患者抑郁症状的患病率和严重程度，并确定与出现此类症状相关的危险因素。
本横断面研究纳入了2019年10月5日至2020年3月中旬期间接受择期PCI并诊断为CAD的所有患者。CAD定义为一条或多条冠状动脉腔内狭窄≥50%。在PCI十天后使用患者健康问卷-9（PHQ-9）工具筛查抑郁症状。使用线性回归模型评估自变量对PHQ-9评分的校正效应。回顾了电子病历、临床图表以及PCI和超声心动图报告。
在385例CAD患者中，本研究共纳入335例，应答率为87%。参与者的平均（±标准差）年龄为57.5±10.7岁，75.2%为男性，43%为当前吸烟者，73.7%的人学历低于本科。中度至重度抑郁症状（PHQ-9≥10）患者的患病率估计为34%，轻度抑郁为45.1%，正常为20.9%。在我们的队列中，女性、低教育水平和糖尿病被发现是抑郁症的重要独立预测因素，其t值分别为（t(333)=3.68，<0.001）；（t(333)=5.13，<0.001）；以及（t(333)=2.79，=0.042）。
本研究表明，PCI十天后CAD患者中抑郁症状的患病率较高。大约三分之一的CAD患者有明显的抑郁症状，这对临床医生来说是一个惊人的发现。此外，本研究表明在类似的研究环境中缺乏足够的抑郁症识别和管理。建议在CAD患者PCI后尽快将心理健康评估和治疗纳入其中，以实现最佳和有效的治疗并获得最佳结果。
