Age, Creatinine, and Ejection Fraction (ACEF) Score is Associated with the Presence of Depression and Anxiety Symptoms in PCI Patients.

BACKGROUND

A significant proportion of patients after percutaneous coronary intervention (PCI) have or develop comorbid depression and/or anxiety symptoms, which are associated with adverse events. The age, creatinine, and ejection fraction (ACEF) score is a good predictor for the prognostic assessment of certain cardiac diseases. But it has never been used to predict post-PCI depression and anxiety symptoms.

AIM

To evaluate the possible association among ACEF score at admission, post-PCI anxiety, depression, comorbid anxiety and depression symptoms in hospital.

METHODS

After exclusion, a total of 222 patients undergoing emergency or selective PCI were enrolled and completed Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression symptoms before discharging. Patients were divided into four groups according to HADS score (anxiety, depression, comorbid anxiety and depression, neither anxiety nor depression). Logistic regression, linear regression and smoothed curve fitting (based on the penalized spline method) were used to analyze the relationship between ACEF score and post-PCI anxiety, depression symptoms. Receiver operating characteristic (ROC) curve analysis were performed to assess the value of ACEF score for predicting post-PCI anxiety, depression, comorbid anxiety and depression symptoms and to determine its critical values.

RESULTS

Of the sample, the number of patients who were diagnosed with post-PCI anxiety, depression and comorbid anxiety and depression symptoms were 16 (7.2%), 33 (14.9%) and 37 (16.7%), which increased with the ACEF score quartiles. In multivariate-adjusted logistic regression analysis, the odds ratios (ORs) of post-PCI anxiety, depression symptoms were 7.701 (1.613-36.766), 6.173 (1.608-28.028) for the lowest quartile of ACEF score compared with the highest quartile. Multivariate-adjusted linear regression and smoothed curve fitting analysis demonstrated that post-PCI anxiety and depression scores increased with higher ACEF scores, indicating a nonlinear positive correlation. The ROC curve showed that ACEF score was a good predictor for post-PCI anxiety, depression and comorbid anxiety and depression symptoms.

CONCLUSION

Higher ACEF score is positively correlated with the prevalences of anxiety and depression symptoms after PCI in hospital, suggesting that ACEF score can be a valid predictor of depression and anxiety symptoms.