Risk Factors for Post–Acute Coronary Syndrome Depression

Abstract

Background: The incidence of depression is very common among patients with post–acute coronary syndrome (ACS) and leads to adverse outcomes. Aims: The aim of this meta-analysis was to detect risk factors for depression among patients with ACS and to provide clinical evidence for its prevention. Methods: The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline to search the PubMed, Web of Science, EMBASE, and EBSCO databases from January 1996 to March 2018. Data that met the inclusion criteria were extracted to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk factors of post-ACS depression. Results: A total of 30 articles met the inclusion criteria, and 25 risk factors were found to be associated with depression. The top 5 risk factors are as follows: antidepression treatment (OR, 4.25; 95% CI, 3.41–5.31), housewife status (OR, 4.17; 95% CI, 1.83–9.53), history of depressive disorders (OR, 3.52; 95% CI, 2.69–4.61), widow status (OR, 2.34; 95% CI, 1.05–5.21), and history of congestive heart failure (OR, 2.03; 95% CI, 1.04–3.97). The authors also found that a married status, high education level, and employment are protective factors. Conclusion: Clinical personnel should be alerted with regard to the high risk factors of depression, including female gender, low education level, unmarried status, living alone, unemployed status, unhealthy lifestyle, and complications such as cardiovascular, respiratory, and metabolic diseases. In particular, staff should pay attention to a history of previous depression, be concerned with the psychological condition of the patient, and monitor and perform early interventions to reduce the incidence of depression.

Temperament and Depression After a First Acute Coronary Syndrome

“…Results that women and widowhood represent risk factors for the development of post-ACS depression is in line with data both in the cardiac population (Yuan et al, 2019) and in the general population of similar age (Cole and Dendukuri, 2003).…”

A systematic review and meta‐analysis of mindfulness‐based interventions for patients with coronary heart disease

“…Psychological symptoms such as depression, anxiety and stress are common in patients with CHD and may lead to substantial negative consequences (Cohen et al., 2015; Wang et al., 2008). According to a meta‐analysis, the prevalence of clinically significant depressive symptoms or a diagnosis of major depressive disorder ranges from 5–69.3% in patients after heart attacks (Yuan et al., 2019). A large prospective study also showed that approximately 49.1% and 40.2% of this population experienced symptoms of anxiety and stress (Goldberg et al., 2015).…”

A potential impact of physical distancing on physical and mental health. A rapid narrative umbrella review of meta-analyses on the link between social isolation and health

“…In particular, longitudinal data indicate that social isolation is associated with increased risk of several physical and mental health outcomes, cardiovascular disease, hospital readmission in heart failure patients, early mortality, cognitive impairment, and depression. 3,[23][24][25]27,[36][37][38][39][40] However, the findings are all based on observational studies and do not provide evidence on the causal direction of the association. Poor physical and mental health can lead to social isolation, and social isolation can lead to poorer health.…”

“…[28][29][30] The included meta-analyses based on cross-sectional designs reported a significant positive association between social isolation and late-life suicidal ideation, 31 depression in adults, 32 late life depression, 26 psychosis, 28,33,34 smoking behavior in adolescents, 29 depression and social anxiety in childhood and adolescence, 28,30 and social anxiety disorder in adults. 35 The meta-analyses based on longitudinal studies suggest that social isolation is associated with higher risk of depression in adults, 36 post-acute coronary syndrome depression, 37 and dementia and cognitive impairment in later life. 27,[38][39][40] See Table 1 for detailed information.…”