Anxiety-depressive disorders in patients with coronary artery disease with borderline coronary artery stenosis and visceral obesity

Abstract

Aim. To assess the prevalence of anxiety-depressive disorders in pa­tients with coronary artery disease (CAD) with borderline coronary artery (CA) stenosis and visceral obesity.Material and methods. The study involved 201 patients with stable CAD with class I-III angina pectoris with borderline (50-70%) coronary stenosis. The first group consisted of patients with stable borderline CAD with increased epicardial fat thickness (EFT) — 57 (28,4%) people, the second group — patients without increased EFT — 144 (71,6%) people. Blood biochemical tests, levels of inflammatory markers (high-sensitivity C-reactive protein, interleukin (IL)-1, IL-6, IL-8, IL-10, tumor necrosis factor alpha, N-terminal pro-brain natriuretic peptide) were assessed. Cardiac ultrasound was used to determine EFT. All patients underwent coronary angiography. Levels of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS).Results. The average EFT in group 1 was 6,00 [5,00; 6,50] mm, in group 2 — 3,00 [2,30; 4,00] mm (p<0,001). In group 1 patients, hypertension (p<0,001), coronary artery disease (p<0,001) in general and myocardial infarction (p=0,003) in particular debuted at a younger age. The groups did not differ significantly in the incidence of obesity, type 2 diabetes, functional class of angina, or the intake rate of all 4 main drug groups. Patients with increased EFT were more likely to have elevated levels of N-terminal pro-brain natriuretic peptide (p=0,002), high-sensitivity C-reactive protein (p=0,027), as well as higher values (p=0,005) and a higher frequency of increasing (p<0,001) the antiinflammatory cytokine IL-10. When analyzing the anxiety-depressive profile, the sum of depression scores and the incidence of subclinical depression were significantly (p<0,001) higher in the group of patients with increased EFT.Conclusion. Patients with stable CAD with borderline coronary artery stenosis and increased EFT, which is a marker of visceral obesity, are characterized by an earlier age of manifestation of hypertension and coronary artery disease, the presence of a pro-inflammatory phenotype and a higher level of subclinical depression.