Association of Anxiety and Depression in Patients Undergoing Cardiac Catheterization With Number of Major Coronary
Dipak R Das1, Mihir R Nayak2, Debjyoti Mohapatra3,4
1Cardiology, Srirama Chandra Bhanja (SCB) Medical College and Hospital, Cuttack, IND.
Insights
Anxiety and depression are highly prevalent in coronary artery disease patients. Higher anxiety and depression scores correlate with more severe triple-vessel disease, indicating a need for targeted mental health screening and management in these individuals.
Area of Science:
- Cardiology
- Psychiatry
- Medical Imaging
Background:
- The relationship between anxiety, depression, and coronary artery disease (CAD) is complex and potentially bidirectional.
- Existing literature has limited data on the association between anxiety/depression levels and the extent of coronary artery involvement.
- Understanding this link is crucial for comprehensive patient care in cardiovascular medicine.
Purpose of the Study:
- To investigate the prevalence of anxiety and depression in patients undergoing cardiac catheterization.
- To determine the association between the severity of anxiety and depression and the number of coronary arteries involved in CAD.
- To provide insights for improved patient management strategies in cardiovascular care.
Main Methods:
- Prospective study involving patients undergoing cardiac catheterization at a tertiary care hospital in India.
- Coronary artery disease diagnosis confirmed via clinical assessment, ECG, echocardiography, or biomarkers, followed by coronary angiography.
- Anxiety and depression levels assessed using the Hospital Anxiety and Depression Scale (HADS) during admission and pre-catheterization.
Main Results:
- High prevalence of anxiety (83.3%) and depression (77.8%) observed in the study population.
- Severe anxiety (31.5%) and severe depression (38.9%) were notably present.
- Significantly higher HADS anxiety and depression scores were found in patients with triple-vessel disease compared to those with single or double-vessel disease.
Conclusions:
- Anxiety and depression are highly prevalent comorbidities in coronary artery disease patients.
- The severity of anxiety and depression correlates with the extent of coronary artery disease, particularly triple-vessel disease.
- Routine screening and management of psychological distress are essential components of holistic care for CAD patients, especially those with multi-vessel involvement.
Abstract:
Introduction The relationship between the level of anxiety and depression among coronary artery disease (CAD) patients and coronary angiographic findings is ambiguously mentioned in studies. Past evidence shows that the relationship between anxiety and depression with coronary artery disease can be bidirectional. There is a paucity of literature on the association of levels of anxiety and depression with the number of coronary arteries involved in coronary artery disease. Methods This study was conducted in a tertiary care hospital to find the level of anxiety and depression in patients undergoing cardiac catheterization and their association with the numbers of the major coronary artery involved. Patients undergoing cardiac catheterization in the Department of Cardiovascular Science of a tertiary care hospital in India from May 2020 to December 2020 were considered for inclusion in the study. Coronary artery disease was diagnosed based on the combination of clinical, ECG, echocardiography, or biomarker parameters in various combinations. These patients were further subjected to coronary angiogram to know the extent of stenosis and the number of coronary vessels involved in the disease. The level of anxiety and depression was measured by using the Hospital Anxiety and Depression Scale (HADS) during the period of admission and at least 24 hours after diagnosis and at least 12 hours before cardiac catheterization. The data was entered into SPSS software version 22.0 (Armonk, NY: IBM Corp.) for statistical analysis. Chi-square test, Kolmogorov-Smirnov test, and Kruskal-Wallis test were used for the interpretation of data and find an association between severity of anxiety and depression with the number of major coronary vessels involved. Results Anxiety was seen in 83.3% of the patients with 31.5% having severe anxiety. Depression was found in 77.8% with 38.9% suffering from severe depression. The anxiety and depression scores of HADS were significantly higher in those with triple-vessel disease compared to the double-vessel or single-vessel disease. Conclusion Screening and management of anxiety and depression is an essential part of the care of patients with coronary artery disease. People with triple-vessel disease need the most attention and appropriate management of anxiety and depression.
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