Background and purpose: Anxiety is a common condition among acute coronary syndrome (ACS) patients. This syndrome often goes unrecognised and can persist for months to years, while impacting substantially the quality of life. Therefore, this study aimed to identify the associated factor of anxiety among ACS patients in Hospital Universiti Sains Malaysia (USM) and Hospital Sultanah Nur Zahirah (HSNZ). Materials and Methods:This cross-sectional study involved ACS patients admitted to Hospital USM, Kelantan and HSNZ, Terengganu between August 2014 and May 2015. A standardised questionnaire was developed to interview the respondents. The questionnaire was separated into two sections. The first section comprised the socio-demographic details of the patients. The second section was the validated Depression Anxiety Stress Scale 21 (DASS-21) questionnaire. Simple and multiple logistic regressions were used for analysing the collected data. Results: The mean (standard deviation (SD)) age of ACS patients was 60.4 (11.3) years and 61.2 (10.4) years in Hospital USM and HSNZ respectively. The majority of ACS patients who experienced anxiety were male (86.3%) with 84.9% of them Malay ethnicity and 85.9% of them married. The factor associated with anxiety among ACS patients was having a history of ischemic heart disease (adjusted odd ratio (OR): 2.20, as well as confidence interval (CI): 1.19, 4.10, p=0.013). Conclusion: It was concluded that anxiety had myriad effects on cardiovascular physiology, which plays an important role in the increased incidence of ischemic events in patients. A screening tool should be created to refine and identify the psychological status of ACS patients, so that early treatment could be given.

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Background: Stress often happens in acute coronary syndrome (ACS) patients, especially during hospitalization. Objectives: The current study intended to identify the prevalence of stress and its associated factors among ACS patients in two selected hospitals in the east coast region of Malaysia. Methods: A total of 400 ACS patients in both hospitals participated in this cross-sectional study. Acute coronary syndrome patients above 18 who can read, speak and understand in Malay and obtained informed consent were included in the study. The study excluded those patients who were intubated, had any altered mental status, were mentally retarded, and had psychological problems. Stress among ACS patients was measured using the validated questionnaire of the Malay version of the Depression Anxiety Stress Scale 21. Logistic regression was used for analysis. Results: Of these ACS patients, 58.5% had stress symptoms. A higher frequency of stress was found in patients of male (63.7%), Malay (82.1%), and married (67.1%). Acute coronary syndrome patients with a history of ischemic heart disease were a strong and independent factor associated with stress (adjusted odds ratio: 1.73, 95% confidence interval: 1.14 - 2.63, P = 0.010). Conclusions: The prevalence of stress in the study population was high and significantly associated with a history of ischemic heart disease. Creating awareness regarding the risk factors of stress is recommended. In addition, policies should be implemented to reduce the risk of stress among patients.

Background and purpose: Linked with high mortality rate, depression is common among acute coronary syndrome (ACS) patients. The current study sought to identify the factors associated with depression among ACS patients in Malaysia. Materials and Methods: A cross-sectional study was conducted on 400 ACS patients in two Malaysian hospitals: Hospital Universiti Sains Malaysia (USM), Kelantan and Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. ACS patients were included if they were above 18 years of age, able to read and/or write in Bahasa Melayu language and had informed consent. Patients were excluded if they were intubated, had an altered mental status, mental retardation and had psychological problems prior to ACS. Depression in this study was defined as having dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest or involvement, anhedonia, and inertia among ACS patients. A questionnaire was distributed to all 400 ACS patients. Simple and multiple logistic regressions were used for data analysis. Results: The mean (standard deviation) age of ACS patients was 60.4 (11.3) years at Hospital USM and 61.2 (10.4) years at HSNZ. Nearly all of the depressive-ACS patients were Malay (79.4%), 85.9% were male, and 79.7% were married. Approximately 87.7% of depressive-ACS patients had ischemic heart disease, 87.1% had stroke, 83.4% had hyperlipidaemia, 81.8% had diabetes mellitus, and 80.7% had hypertension. The factors associated with depression were female gender (adjusted odd ratio (OR): 2.48, 95% confidence interval (CI): 1.50, 4.10, p<0.001) and ischemic heart disease (adjusted OR: 2.44, 95% CI: 1.41, 4.25, p=0.002). Conclusion: The results showed that female gender and ischemic heart disease were the most significant associated factors of depression among ACS patients.