Manifestation of the Affective Spectrum Disorders in Patients With Acute Myocardial Infarction Depending on the Treatment Tactics

Abstract

Today, cardiovascular disease and anxiety-depressive disorders are the most serious and urgent medical and social problem around the world. The purpose of this study was to determine the severity of anxiety-depressive disorders in patients with acute myocardial infarction, depending on the treatment tactics as a precondition for the drug therapy correction. We studied 73 patients with the above-mentioned pathology, who were divided into two groups: I group included 44 patients who underwent percutaneous coronary intervention, in particular, urgent coronary angiography with subsequent stenting of the infarction-related coronary artery; the II group included 29 patients, who did not undergo urgent coronary angiography. The examination of patients was conducted in accordance with Ukrainian standards, using the patients’ questionnaire on their health status, the hospital scale of anxiety and depression. Mild ("subclinical") depression was diagnosed according to the patient's questionnaire in 81,9% of patients with acute myocardial infarction who underwent the stenting of the infarction-related artery; while 86.2% of the patients without surgical intervention who received only pharmaceutical therapy were diagnosed to have mild (“subclinical") and severe forms of depression. According to the hospital scale of anxiety and depression, 36,4% of the patients with acute myocardial infarction after percutaneous coronary intervention were diagnosed to have depression and the 34,1 % of the patients were found to have anxiety. 62,1% of the patients with acute myocardial infarction, who had not been urgently performed on coronary angiography, demonstrated depression, while 72,4% of the patients were assessed as anxious. For the patients with acute myocardial infarction, who underwent myocardial revascularization with stenting of the infarction-related artery, predominance of subclinical anxiety and depression manifestation is characteristic unlike the patients received the medication only; recurrence has been found as typical for clinically expressed anxiety and depression. The presence of anxiety-depressive disorders of varying severity requires a psychotherapeutic correction of the psycho-emotional sphere in patients with serious cardiovascular diseases.