Anxiety, depression, and cardiac outcomes after a first diagnosis of acute coronary syndrome.

Abstract

Objective. Depression is an established risk factor for Acute Coronary Syndrome (ACS) with an impact on cardiac prognosis, nonetheless the literature disagrees on the role played by anxiety. No study evaluated this relationship in a cardiac population with no history of depression and after their first ACS. The aim of this study is to explore these associations without the confounding role of long-lasting heart disease or psychiatric illnesses. Methods. Two-hundred-sixty-six patients with no history of depression completed the Hospital Anxiety and Depression Scale and the PRIME-MD at baseline and at 1, 2, 4, 6, 9, 12 and 24 months follow-up after their first ACS. During the follow-up period, we collected information regarding the major adverse cardiac events. Results. Developing a first-ever depressive episode, in a proportional hazard model, was associated with almost three times the risk of a recurrent cardiac event (OR=2.590; 95%CI=1.321, 5.078; p=.006). Furthermore, a moderation analysis revealed that increasing levels of baseline anxiety had opposing effects on cardiac outcomes, being protective only in those who did not develop incident depression (B=-0.0824; 95%CI=-0.164,-0.005; p=.048). No dose-response effect between depressive or anxious symptoms and cardiac outcomes emerged. Conclusion. Our results confirm the detrimental effect of depression on cardiac prognosis in a selected population and suggest that anxiety after the first ACS might have different roles depending on the illness' course.

Religious Mosque Leaders (Khateebs): Awareness, Perceptions, Practices and Attitude towards Mental Health, Riyadh Region, Saudi Arabia

“…risk factors underpinning mental disorders, and many studies support such global etiological interpretations (holistic model) of MDs [62][63][64][65]. Of note, majority of Khateebs revealed that stressful life circumstances and biosocial crises compatible with current researches could induce transient depression [66][67][68][69]. Furthermore, almost all Khateebs supported that the main reasons underlying suicide include both the fragile religious faith and mental illnesses, and other studies [70][71][72] partially supported these findings.…”

Temperament and Depression After a First Acute Coronary Syndrome

“…The present study is part of a more extensive investigation on never-depressed patients at their first ACS (Marchesi et al, 2014a(Marchesi et al, , 2014bMarchesi et al, 2015;Ossola et al, 2015aOssola et al, , 2015bOssola et al, , 2018.…”

“…Moreover, 1 in 10 patients with ACS develop depressive symptoms within the following year (Thombs et al, 2006). Depression itself seems to have a negative impact on cardiac prognosis (Lichtman et al, 2014), but the role played by anxiety (de Jager et al, 2018;Ossola et al, 2018), severity of depressive symptoms, and recurrence of the episodes (Osler et al, 2016;Yammine et al, 2017;Zuidersma et al, 2011) is still object for debate.…”

Peculiarities of Platelet Metabolism in Patients with Acute Coronary Syndrome with Anxiety–Depressive Disorders and Informativity of Enzymes in the Forecast of Development of Cardiovascular Complications

“…Platelets play a key role in the hemostatic system [ 18 , 19 , 20 ]. Disturbances in the blood coagulation system are the main pathogenetic link in the development of ACS, and the presence of concomitant ADD may be one of the reasons for the poor prognosis in this category of patients [ 21 , 22 , 23 ].…”