Anxiety after a first acute coronary syndrome : Prevalence and associated factors
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Abstract
ABSTRACT Background: Post Acute Coronary Syndrome (ACS) anxiety is a common manifestation that can interfere with the management of ACS. The identification of patients at risk of developing this disorder will ensure overall management of coronary artery disease. Aim: Estimate the prevalence of post ACS anxiety following a first episode of ACS and identify predictive factors for the onset of this disorder. Methods: We conducted a prospective, multicentric study across four cardiology departments from june to december 2018. We included hospitalized patients for a first episode of ACS. A screening of anxious symptoms was performed using the Hospital Anxiety and Depression Scale, in two stages, in-hospital (T0) and between 30 and 59 days after hospital discharge (T1). Results: We enrolled 122 patients. The prevalence of anxiety symptomatology at T0 and T1 was respectively 38.5% and 25.9%. At T0, the independent predictors of anxiety were younger age (p=0,04 ; OR=9,085 ; CI95% :1,021-80,840) and sedentarity (p=0,003 ; OR=27,509 ; CI95% :3,138-241,138). At T1, secondary or higher educational level (p=0,008 ; OR=3,666 ; CI95% :1,41-9,53) and non performing coronary angiography (p=0,027 ; OR=3,754 ; CI95% :1,160-12,149) were the two independent predictors of anxiety. Conclusion: The high prevalence of post ACS anxiety symptomatology reflects the importance of mental health of coronary patients. An overall care within cardiovascular rehabilitation programs is needed to improve the quality of life of patients.
Keywords:
Acute coronary syndrome, Anxiety, Risk factors, Prevention##plugins.themes.academic_pro.article.details##
References
- 1. World Health Organization. Noncommunicable diseases country profiles 2014. Geneva: WHO; 2014. 2. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the interheart study): case control study. Lancet Lond Engl. 2004;364(9438):937‑52. 3. EUROASPIRE II Study Group. Lifestyle and risk factor management and use of drug therapies in coronary patients from 15 countries; principal results from EUROASPIRE II Euro Heart Survey Programme. Eur Heart J. 2001;22(7):554‑72. 4. Mozaffarian Dariush, Benjamin Emelia J., Go Alan S., Arnett Donna K., Blaha Michael J., Cushman Mary, et al. Heart Disease and Stroke Statistic 2016 Update. Circulation. 2016;133(4):e38‑360. 5. Altino DM, Nogueira-Martins LA, de Barros ALBL, Lopes J de L. Predictive Factors of Anxiety and Depression in Patients with Acute Coronary Syndrome. Arch Psychiatr Nurs. 2017;31(6):549‑52. 6. Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure Smith N, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the american heart association. Circulation. 2014;129(12):1350‑69. 7. Doering LV, Moser DK, Riegel B, McKinley S, Davidson P, Baker H, et al. Persistent comorbid symptoms of depression and anxiety predict mortality in heart disease. Int J Cardiol. 2010;145(2):188‑92. 8. Vaccarino V, Badimon L, Bremner JD, Cenko E, Cubedo J, Dorobantu M, et al. Depression and coronary heart disease: 2018 position paper of the ESC working group on coronary pathophysiology and microcirculation. Eur Heart J. 2020;41(17):1687‑96. 9. American Psychiatric Association (2013). DSM-V-TR: Diagnostic and statistical manual of mental disorders (5th ed.), 2013. American Psychiatric Association Arlington. 10. Ossola P, Paglia F, Pelosi A, De Panfilis C, Conte G, Tonna M, et al. Risk factors for incident depression in patients at first acute coronary syndrome. Psychiatry Res. 2015;228(3):448‑53. 11. Lane D, Carroll D, Ring C, Beevers DG, Lip GY. Effects of depression and anxiety on mortality and quality of life 4 months after myocardial infarction. Psychosom Res. 2000;49:229-38. 12. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361‑70. 13. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety and depression scale. an updated literature review. J Psychosom Res. 2002;52(2):69‑77. 14. Hanssen TA, Nordrehaug JE, Eide GE, Bjelland I, Rokne B. Anxiety and depression after acute myocardial infarction: an 18-month follow-up study with repeated measures and comparison with a reference population. Eur J Cardiovasc Prev Rehabil. 2009;16(6):651‑9. 15. Michael AJ, Krishnaswamy S, Muthusamy TS, Yusuf K, Mohamed J. Anxiety, Depression and Psychosocial Stress in Patients with Cardiac Events. Malays J Med Sci. 2005;12(1):57‑63. 16. Murphy B, Le Grande M, Alvarenga M, Worcester M, Jackson A. Anxiety and Depression After a Cardiac Event: Prevalence and Predictors. Front Psychol [cité le 17/05/2020]; [environ 10 écrans]. Disponible à l'URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000459/ 17. El Ghardallou M, Zedini C, Bejaoui R, Limam M, Ben Dhiab M, Ajmi T. La prévalence et les facteurs associés à la dépression et à l'anxiété chez les patients ayant eu un infarctus du myocarde, Tunis, Tunisie. Rev Epidemiol Sante Publique. 2016;64(4):229-33. 18. Lavie CJ, Milani RV. Adverse psychological and coronary risk profiles in young patients with coronary artery disease and benefits of formal cardiac rehabilitation. Arch Intern Med. 2006;166(17):1878‑83. 19. Kuhl EA, Fauerbach JA, Bush DE, Ziegelstein RC. Relation of anxiety and adherence to risk-reducing recommendations following myocardial infarction. Am J Cardiol. 2009;103(12):1629‑34. 20. Murphy BM, Grande MRL, Navaratnam HS, Higgins RO, Elliott PC, Turner A, et al. Are poor health behaviours in anxious and depressed cardiac patients explained by sociodemographic factors? Eur J Prev Cardiol. 2013;20(6):995‑1003. 21. Poirel E. Bienfaits psychologiques de l'activité physique pour la santé mentale optimale. Sante Ment Que. 2017;42(1):147‑64. 22. Bjelland I, Krokstad S, Mykletun A, Dahl AA, Tell GS, Tambs K. Does a higher educational level protect against anxiety and depression? The HUNT study. Soc Sci Med; 2008;66(6):1334‑45. 23. Ben Halima G, Cherif W, Ben Aoun M, Cherif F, Gueddiche F, Ben Slima H, et al. Incidence et facteurs de risque de la dépression post syndrome coronarien aigu : étude prospective auprès de 110 patients. Ann Cardiol Angéiologie. 2020;69(3):125‑32 24. O'Keefe-McCarthy S, McGillion M, Clarke SP, McFetridge-Durdle J. Pain and anxiety in rural acute coronary syndrome patients awaiting diagnostic cardiac catheterization. J Cardiovasc Nurs. 2015;30(6):546‑57. 25. Meneghetti CC, Guidolin BL, Zimmermann PR, Sfoggia A, Meneghetti CC, Guidolin BL, et al. Screening for symptoms of anxiety and depression in patients admitted to a university hospital with acute coronary syndrome. Trends Psychiatry Psychother. 2017;39(1):12‑8.