Chinese patients’ clinical and psychosocial outcomes in the 6 months following percutaneous coronary intervention

Abstract

Background In China, there has been a precipitous increase in the number of percutaneous coronary interventions (PCI) conducted. We sought to characterize the clinical and psychosocial trajectory of PCI patients from the time of procedure through 6 months post, and correlates of adverse cardiovascular events (ACEs). Methods In this prospective, observational study, patients from 2 hospitals in Shanghai, China were assessed. At follow-up visits at 1, 3 and 6 months post-PCI, clinical indicators were again extracted from patients’ clinical records, including ACEs, and they completed validated surveys assessing self-management, as well as psychosocial indicators (Hospital Anxiety and Depression Scale; Pittsburgh Sleep Quality Index; quality of life [QoL]: SF-12, Seattle Angina Questionnaire [SAQ]). Repeated measures analysis of variance, adjusted for Barthel index and PCI indication, was used to assess change over time in risk factors and psychosocial indicators. Logistic regression was used to explore correlates of ACEs. Results 610 participants (mean age = 63.3; n = 150, 18.2% female) were recruited, of which 491 (80.5%) were retained at 6 months. 82 (16.7%) had an ACE at any time point, including most commonly angina and stroke (only 1 death). Clinical indicators such as blood pressure (p < 0.031 for both), symptom burden (p < .01 on all subscales) and QoL (p < 0.001 for both, but started quite low) improved over 6 months. Anxiety and depressive symptoms were above threshold, and the latter worsened over time (p < 0.001). With adjustment for age and indication, patients with any ACEs had higher sleep latency (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.03–2.10]), and depressive symptoms (OR = 1.20; 95% CI = 1.02–1.41), but lower anxiety (OR = 0.79; 95% CI = 0.67–0.93) compared to those without. Conclusion Centers may wish to re-visit patient selection criteria and processes for PCI, as well as implement mental health screening and treatment protocols, as can be achieved through cardiac rehabilitation, given how hazardous psychosocial distress is in this population.

Higher Neutrophil to Lymphocyte Ratio at Admission is Association with Post-PCI Depressive Symptoms in Patients with ACS

“… 3 The diagnosis of post-PCI depressive symptoms is a dynamic process, with different manifestations in different time stages, and the conclusions of different studies are quite different, which may be related to the timing of post-PCI depressive symptoms determination, psychological assessment methods, and different criteria for evaluation. 24 The gensini scores reflect the severity of coronary artery stenosis. Our results showed that gensini scores were risk factors for the development of post-PCI depressive symptoms, which was broadly consistent with the recent studies.…”

Feasibility study of rehabilitation for cardiac patients aided by an artificial intelligence web-based programme: a randomised controlled trial (RECAP trial)—a study protocol

“…The HADS score is derived using a validated questionnaire and is widely used within CR to assess cardiac patients’ level of anxiety and depression 29 30. The Barthel index is used for assessment of performance in basic activities of daily living 31–33. The CFS is a clinical judgement-based frailty tool and is widely used in the assessment of cardiac patients 24 34…”

“…29 30 The Barthel index is used for assessment of performance in basic activities of daily living. [31][32][33] The CFS is a clinical judgement-based frailty tool and is widely used in the assessment of cardiac patients. 24 34 The participant's medical notes will be used to collect a full medical history and information, including their sex and date of birth.…”

Research Progress on the Depression Status and Nursing Intervention in Patients after Percutaneous Coronary Intervention

“…Yang [16] investigated post-PCI patients with CHD in three hospitals in Changsha, and found that the incidence rate of post-PCI patients harboring negative emotions (including depression, anxiety, and irritability) was 63.8%, with depression being the highest at 39.6%. A 6-month longitudinal observational study [17] found that more than half of post-PCI patients experienced constant anxiety and depression for 6 months. Furthermore, the depression gradually worsened over time and adversely affected the prognosis.…”