Risk Factors for Post-Acute Coronary Syndrome Depression: A Meta-analysis of Observational Studies
Mei-Zhen Yuan1, Qin Fang, Guang-Wei Liu
1Mei-zhen Yuan, MD Clinical Nurse, Department of Cardiovascular Medicine, The First Affiliated Hospital, Chongqing Medical University, China. Qin Fang, MD Associate Professor, Department of Cardiovascular Medicine, The First Affiliated Hospital, Chongqing Medical University, China. Guang-wei Liu, MD Associate Professor, Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, China. Min Zhou, MD Clinical Nurse, Department of Cardiovascular Medicine, The First Affiliated Hospital, Chongqing Medical University, China. Jian-mei Wu, MD Clinical Nurse, Department of Cardiovascular Medicine, The First Affiliated Hospital, Chongqing Medical University, China. Chun-yun Pu, MD Clinical Nurse, Department of Cardiovascular Medicine, The First Affiliated Hospital, Chongqing Medical University, China.
Background:
The incidence of depression is very common among patients with post-acute coronary syndrome (ACS) and leads to adverse outcomes.
Aims:
The aim of this meta-analysis was to detect risk factors for depression among patients with ACS and to provide clinical evidence for its prevention.
Methods:
The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline to search the PubMed, Web of Science, EMBASE, and EBSCO databases from January 1996 to March 2018. Data that met the inclusion criteria were extracted to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk factors of post-ACS depression.
Results:
A total of 30 articles met the inclusion criteria, and 25 risk factors were found to be associated with depression. The top 5 risk factors are as follows: antidepression treatment (OR, 4.25; 95% CI, 3.41-5.31), housewife status (OR, 4.17; 95% CI, 1.83-9.53), history of depressive disorders (OR, 3.52; 95% CI, 2.69-4.61), widow status (OR, 2.34; 95% CI, 1.05-5.21), and history of congestive heart failure (OR, 2.03; 95% CI, 1.04-3.97). The authors also found that a married status, high education level, and employment are protective factors.
Conclusion:
Clinical personnel should be alerted with regard to the high risk factors of depression, including female gender, low education level, unmarried status, living alone, unemployed status, unhealthy lifestyle, and complications such as cardiovascular, respiratory, and metabolic diseases. In particular, staff should pay attention to a history of previous depression, be concerned with the psychological condition of the patient, and monitor and perform early interventions to reduce the incidence of depression.
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