Depressive Symptoms and Complications Early after Acute Myocardial Infarction: Gender Differences

Abstract

Background:Cardiovascular disease is the first leading cause of death worldwide. Coronary heart disease is the most common manifestation of cardiovascular disease. Acute myocardial infarction is the primary manifestation of coronary heart disease. Depression is a common and predicted complication after acute myocardial infarction. Limited studies evaluated gender differences in depressive symptoms after acute myocardial infarction especially in developing countries.Objective:The study aimed to determine whether there was a difference in depression levels and rate of complications based on gender early after acute myocardial infarction.Method:This was a prospective comparative study on 230 patients (150 men and 80 women) with a confirmed diagnosis of acute myocardial infarction. All participants signed an informed consent, filled sociodemographic and clinical questionnaire and the Depression Subscale of the Hospital Anxiety and Depression Scale. Clinical data were abstracted from the participants’ medical record after discharge.Results:Eighty-six participants (37.4%), 54 men and 32 women, developed 1 or more complications during hospitalization. Female patients were more depressed (14.4±3.5 vs. 8.3 ± 2.6) and developed more complications (1.9 ± 0.9 vs. 0.8 ± 0.5) than male patients did. Depressive symptoms increased the occurrence of complication by 40% and 33% for female and male patients respectively after controlling for sociodemographic and clinical variables.Conclusion:Depressive symptoms independently predicted complications after acute myocardial infarction in both men and women. The inclusion of depression assessment tools in acute myocardial infarction treatment protocols is highly recommended.

Patients with ST segment elevation myocardial infarction: moderating effect of perceived control on the relationship between depression and in-hospital complications

“…depression and anxiety) [3, 31]. Depression and PC were both independent predictors of these complications, affirming the findings of previous studies on the former predictor [4–6, 36]: PC militates against depression, while the latter predisposes patients to such complications, the most prolific of which was acute recurrent ischemia [3, 4, 7, 8, 31]. Approximately one-quarter (24%) of participants in this study developed some form of complication.…”

“…Depression-measuring tools may have wide indications spanning numerous forms of illness, including subclinical CHD. In this study, HADS was used to measure depression, to differentiate depression among physically ill patients, which removes somatic indications that can obscure factors of heart disease but which may blunt depression detection [3, 6, 35]. As a result, this study is conservative in its estimation of the significance of the relationship between in-hospital complications and depression.…”

“…Arabic HADS was used to assess depression. Numerous cardiac studies affirm its psychometric proprieties (Cronbach’s α 0.87) [6, 32–35]. The seven items are rated on a four-point Likert scale, ranging from 0 to 3, where 3 refers to the maximum severity and frequency of symptoms.…”

“…The seven items are rated on a four-point Likert scale, ranging from 0 to 3, where 3 refers to the maximum severity and frequency of symptoms. The values assigned for each item add up to a net score ranging from 0 to 21, which are then classified according to depression severity as normal (0–7), mild (8–10), moderate (11–14), and severe (15–21) [6, 32]. In-Hospital Complications…”

“…Previous studies have found evidence that depression is associated with short- and long-term complications after AMI. In the short term, starting as early as the first 20 min after AMI [6–9], depression was an independent predictor of complications such as acute recurrent ischemia, re-infarction, ventricular tachycardia, ventricular fibrillation, cardiogenic shock, pulmonary edema, inflammation (i.e., endocarditis), left ventricular mural thrombus, and in-hospital death [3, 4, 6, 7, 10]. Moreover, high levels of depression were associated with higher levels of fatigue and longer hospitalization, especially in critical care units [4], and lower levels of left ventricular ejection fraction (LVEF) [11].…”