Association between anxiety and depression in patients with acute coronary syndromes due to financial crisis

Abstract

A b s t r a c t Background:The effect of anxiety and depression on patients with acute coronary syndromes (ACS) warrants investigation, especially during periods of economic crisis. Aim:To investigate the relation between anxiety and depression in patients presenting with ACS due to financial crisis and to investigate whether these two entities could predict long-term cardiovascular mortality. Methods and results:Anxiety and depression symptoms were assessed in 350 patients (210 men) presenting with ACS, with 70 (20%) patients showing elevated scores (Hellenic Heart Failure Protocol). Over a mean follow-up of 48 months there were 36 (10%) cardiovascular deaths. Cox proportional hazards models adjusted for other prognostic factors (including age, sex, marital status, creatinine levels, left ventricular ejection fraction, heart failure, atrial fibrillation, previous hospitalisation, and baseline medications) showed that elevated anxiety and depression scores significantly predicted cardiovascular mortality (primary outcome) and all-cause mortality.Conclusions: Elevated anxiety and depression symptoms are related to cardiovascular mortality due probably to financial crisis, even after adjustment for other prognostic indicators in patients with ACS, who received optimised medical treatment.

Stability and change of lifestyle profiles in cardiovascular patients after their first acute coronary event

“…At T1 and T2 differences in preceding measures of depression and anxiety among lifestyle clusters were assessed to explore the possible association of these psychological variables with subsequent behavioral change. Depression and anxiety have been selected for their significant associations to ACS onset and recurrence [ 15 – 16 ], and for their effect on patients’ likelihood to adhere to lifestyle modification programs and then to effectively quit smoking, adopt a healthier diet and be more physically active [ 17 – 20 ]. At each wave the associations between cluster membership and HR were also explored.…”

Marriage and mortality after acute coronary syndrome

“…As illustrated in Supplementary Figure 1, 14 potentially eligible studies with a total of 89,176 patients were identified (Table 1) (see Supplementary References 4–7). 1–10 The risk of bias of each study is summarised in Supplementary Table 1. Extracted and calculated ORs/HRs are listed in Table 1.…”

“…Adjusted ORs for early (one-day, 4 inhospital 6,7 and 30-day (see Supplementary Reference 5)) 8 mortality were available in five studies (see Supplementary Reference 5), 4,6–8 and adjusted HRs for overall (one-year 8 to 77-month (see Supplementary Reference 6)) mortality were available in eight studies (see Supplementary References 4 and 6). 1,2,5,8–10…”

“…In the primary meta-analysis combining adjusted ORs (of early mortality) and HRs (of overall mortality) for married versus unmarried (unmarried (see Supplementary References 4 and 6), 7,8–10 never married (see Supplementary Reference 5), 2,4,5 and single) 1,6 patients demonstrated that married patients were associated with significantly lower early (OR 0.55, 95% CI 0.36–0.86; I 2 = 87%, P = 0.008; Figure 1, upper panel) and overall mortality (HR 0.75, 95% CI 0.65–0.87; I 2 = 55%, P = 0.0001; Figure 1, lower panel) compared with unmarried patients. In several studies (see Supplementary References 4 and 5), 1,2,4,5–7 multiple ORs/HRs (in addition to the OR/HR for married vs. unmarried patients) were available (e.g.…”