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Prevalence and predictors of depression and anxiety among survivors of myocardial infarction due to spontaneous coronary artery dissection

LIANG JJ; TWEET MS; HAYES BM; GULATI R; HAYES SN
J CARDIOPULM REHABIL PREV , 2014, vol. 34, n° 2, p. 138-142
Doc n°: 168147
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1097/HCR.0000000000000030
Descripteurs : FA333 - INFARCTUS DU MYOCARDE

Depression and anxiety after myocardial infarction (MI) are common and
associated with increased morbidity and mortality. The epidemiology and
pathophysiology of MI due to spontaneous coronary artery dissection (SCAD)
differs substantially from atherosclerotic MI, and rates of mental health
comorbidities after SCAD are unknown. We aimed to determine the prevalence and
predictors of depression/anxiety in SCAD survivors. METHODS: In this
cross-sectional study, 158 SCAD survivors (97% women; mean age, 45.5 +/- 9.3
years) were screened for depression/anxiety via surveys, including the Patient
Health Questionnaire Depression Scale (PHQ-9) and Generalized Anxiety Disorder
7-Item Scale (GAD-7), a mean 3.7 +/- 4.7 years after SCAD. Comorbidities and
environmental, socioeconomic, and clinical cardiovascular characteristics were
obtained from the surveys. RESULTS: Since their initial SCAD MI, 51 (33%)
patients had received treatment with medications or counseling for depression and
57 (37%) for anxiety. When surveyed, 46 (31.7%) were taking antidepressant or
anxiolytic medications. Overall, mean PHQ-9 (4.1) and GAD-7 (4.7) scores
suggested borderline mild depression/anxiety (normal range: 0-4). Younger age was
associated with higher PHQ-9 (P = .04) and GAD-7 (P = .02) scores. The 19 (12%)
patients with peripartum SCAD had higher mean PHQ-9 (6.7 vs 3.7; P < .0005) and
GAD-7 (8.1 vs 4.3; P = .003) scores. Patients treated with percutaneous coronary
intervention had lower PHQ-9 (1.5; P = .02) and GAD-7 (2.4; P = .004) scores.
CONCLUSIONS: Symptoms of depression/anxiety are common in patients with MI due to
SCAD, particularly younger women and those with peripartum SCAD. The PHQ-9 and
GAD-7 assessments may detect depression/anxiety in SCAD survivors who do not
self-report these disorders, suggesting a role for routine screening in these patients.

Langue : ANGLAIS

Tiré à part : OUI

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