[Transient psychiatric abnormalities in patients with acute myocardial infarction]

Psychiatric abnormalities (PA) are often observed in patients (pts) in the Coronary Care Units. The origin of such abnormalities is not always clear, but it is known that they may aggravate patients status and interfere with further treatment. The aim of this study was to analyze the factors potentially predisposing to the occurrence of PA in pts with acute myocardial infarction (AMI).

The study group consisted of 200 consecutive pts hospitalized due to AMI. In 63 of them (Group A) the in-hospital course was complicated by PA (agitation, anxiety, hallucinations). Sex- and age-matched 63 pts of the remaining 137 pts which had not PA were control group (Group B).

The data related to coronary artery disease history, AMI diagnosis and treatment were withdrawn from hospital reports. Second group of parameters was focused on history of central nervous system (CNS) diseases, vision and audition ability, stimulant or drug addiction. The data about patient's employment and familial status, level of education, self-estimation of quality of life (QoL) in hospital were the third group of parameters. The second and third group of data were questionnaire-based information.

There were no significant differences between groups in arrhythmias, localization of AMI, percentage of pts with high level of education, neither living alone or with family, jobless, retired or employed ones. Also self-evaluation of QoL was distributed similarly. The parameters which differed Group A versus Group B were respectively: history of CNS diseases (48% vs 20%, p<0,05), in particular--CNS traumas (18% vs 2,3%, p<0,05) and ischemic episodes (10% vs 0%, p = 0,039), thrombolytic (non-percutaneous interventional) treatment 23,8 vs 4,6%, p<0,05), handicap of visual ability (16% vs 0%, p--0,012), nicotinism (30% vs 9,1%, p<0,05), left ventricle ejection fraction <40% (34% vs 5%, p<0,05), treatment with atropine (12,7% vs 0%, p = 0,012) or amiodarone (16,7% vs 0%, p = 0,037).

History of neurological diseases, thrombolytic treatment, left ventricle ejection fraction <40%, handicap of visual ability, nicotinism and amiodarone or atropine in pharmacological treatment are factors which may be helpful to predict PA in pts with AMI. Cumulation of such factors increases a risk of occurrence of transient psychiatric abnormalities. Proper psychoactive pretreatment should be applied in pts with such profile in purpose to avoid behavior related complications.