TY - JOUR
T1 - Prevalence and predictors of depression and anxiety among survivors of myocardial infarction due to spontaneous coronary artery dissection
AU - Liang, Jackson J.
AU - Tweet, Marysia S.
AU - Hayes, Sarah E.
AU - Gulati, Rajiv
AU - Hayes, Sharonne N.
PY - 2014/3
Y1 - 2014/3
N2 - PURPOSE: Depression and anxiety after myocardial infarction (MI) are common and associated with increased morbidity and mortality. The epidemiology and pathophysiology of MI due to spontaneous coronary artery dissection (SCAD) differs substantially from atherosclerotic MI, and rates of mental health comorbidities after SCAD are unknown. We aimed to determine the prevalence and predictors of depression/anxiety in SCAD survivors. METHODS: In this cross-sectional study, 158 SCAD survivors (97% women; mean age, 45.5 ± 9.3 years) were screened for depression/anxiety via surveys, including the Patient Health Questionnaire Depression Scale (PHQ-9) and Generalized Anxiety Disorder 7-Item Scale (GAD-7), a mean 3.7 ± 4.7 years after SCAD. Comorbidities and environmental, socioeconomic, and clinical cardiovascular characteristics were obtained from the surveys. RESULTS: Since their initial SCAD MI, 51 (33%) patients had received treatment with medications or counseling for depression and 57 (37%) for anxiety. When surveyed, 46 (31.7%) were taking antidepressant or anxiolytic medications. Overall, mean PHQ-9 (4.1) and GAD-7 (4.7) scores suggested borderline mild depression/anxiety (normal range: 0-4). Younger age was associated with higher PHQ-9 (P = .04) and GAD-7 (P = .02) scores. The 19 (12%) patients with peripartum SCAD had higher mean PHQ-9 (6.7 vs 3.7; P < .0005) and GAD-7 (8.1 vs 4.3; P = .003) scores. Patients treated with percutaneous coronary intervention had lower PHQ-9 (1.5; P = .02) and GAD-7 (2.4; P = .004) scores. CONCLUSIONS: Symptoms of depression/anxiety are common in patients with MI due to SCAD, particularly younger women and those with peripartum SCAD. The PHQ-9 and GAD-7 assessments may detect depression/anxiety in SCAD survivors who do not self-report these disorders, suggesting a role for routine screening in these patients.
AB - PURPOSE: Depression and anxiety after myocardial infarction (MI) are common and associated with increased morbidity and mortality. The epidemiology and pathophysiology of MI due to spontaneous coronary artery dissection (SCAD) differs substantially from atherosclerotic MI, and rates of mental health comorbidities after SCAD are unknown. We aimed to determine the prevalence and predictors of depression/anxiety in SCAD survivors. METHODS: In this cross-sectional study, 158 SCAD survivors (97% women; mean age, 45.5 ± 9.3 years) were screened for depression/anxiety via surveys, including the Patient Health Questionnaire Depression Scale (PHQ-9) and Generalized Anxiety Disorder 7-Item Scale (GAD-7), a mean 3.7 ± 4.7 years after SCAD. Comorbidities and environmental, socioeconomic, and clinical cardiovascular characteristics were obtained from the surveys. RESULTS: Since their initial SCAD MI, 51 (33%) patients had received treatment with medications or counseling for depression and 57 (37%) for anxiety. When surveyed, 46 (31.7%) were taking antidepressant or anxiolytic medications. Overall, mean PHQ-9 (4.1) and GAD-7 (4.7) scores suggested borderline mild depression/anxiety (normal range: 0-4). Younger age was associated with higher PHQ-9 (P = .04) and GAD-7 (P = .02) scores. The 19 (12%) patients with peripartum SCAD had higher mean PHQ-9 (6.7 vs 3.7; P < .0005) and GAD-7 (8.1 vs 4.3; P = .003) scores. Patients treated with percutaneous coronary intervention had lower PHQ-9 (1.5; P = .02) and GAD-7 (2.4; P = .004) scores. CONCLUSIONS: Symptoms of depression/anxiety are common in patients with MI due to SCAD, particularly younger women and those with peripartum SCAD. The PHQ-9 and GAD-7 assessments may detect depression/anxiety in SCAD survivors who do not self-report these disorders, suggesting a role for routine screening in these patients.
KW - anxiety
KW - depression
KW - myocardial infarction
KW - spontaneous coronary artery dissection
KW - women
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U2 - 10.1097/HCR.0000000000000030
DO - 10.1097/HCR.0000000000000030
M3 - Article
C2 - 24280906
AN - SCOPUS:84896710062
SN - 1932-7501
VL - 34
SP - 138
EP - 142
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
IS - 2
ER -