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Dąbek J, Gąsior Z, Styczkiewicz M, Kubica A, Kosior DA, Wolfshaut-Wolak R, Rajzer M, Szynal M, Jankowski P, Kamiński K. Do the Gender and the Number of Comorbidities and the Use of Tertiary Prevention Play a Role in the Severity of Anxiety and Depression in Patients with Coronary Artery Disease? A POLASPIRE II Study. J Clin Med 2024; 13:3812. [PMID: 38999377 PMCID: PMC11242092 DOI: 10.3390/jcm13133812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
Background/Objectives: The need to conduct research on anxiety and depression in patients with coronary artery disease in connection with factors such as gender or implemented tertiary prevention is very important for drawing practical conclusions and, consequently, implementing new recommendations and procedures. The aim of the study was to attempt to answer the question whether gender and the number of comorbidities, as well as the application of tertiary prevention principles, play a role in the severity of anxiety and depression in the studied group of patients with coronary artery disease. Material: The study involved 765 patients from 11 Polish cardiology centers. The presented material is part of the multicenter POLASPIRE II study. Methods: All patients completed The Hospital Anxiety and Depression Scale (HADS) questionnaire, and a medical interview was conducted with them. Conclusions: Although the intensity of anxiety and depression in the studied group of patients was low, gender differentiated them, which, however, did not influence undertaking tertiary prevention activities. In the study group of patients, the number of comorbidities and cardiac incidents/procedures after the event qualifying for the study, as well as preventive actions undertaken, were not associated with the severity of anxiety and depression. In the studied group of patients with coronary heart disease, there was still a large group of people who did not take preventive measures. Therefore, there is a need for systematic education regarding the benefits of implementing them to prevent the progression of the disease and premature death.
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Affiliation(s)
- Józefa Dąbek
- Department of Cardiology, Faculty of Health Sciences, Medical University of Silesia in Katowice, Ziołowa Street 45-47, 40-635 Katowice, Poland; (J.D.); (Z.G.); (M.S.)
| | - Zbigniew Gąsior
- Department of Cardiology, Faculty of Health Sciences, Medical University of Silesia in Katowice, Ziołowa Street 45-47, 40-635 Katowice, Poland; (J.D.); (Z.G.); (M.S.)
| | - Marek Styczkiewicz
- Department of Cardiology, Independent Public Provincial Hospital, Jana Pawła II 10, 43-170 Zamość, Poland;
| | - Aldona Kubica
- Department of Cardiac Rehabilitation and Health Promotion, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland;
| | - Dariusz A. Kosior
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Adolfa Pawińskiego 5, 02-106 Warsaw, Poland;
| | - Renata Wolfshaut-Wolak
- Institute of Nursing and Midwifery, Jagiellonian University Medical College, Michałowskiego 12, 31-008 Krakow, Poland;
| | - Marek Rajzer
- Institute of Cardiology Collegium Medicum, Jagiellonian University, 31-008 Krakow, Poland;
| | - Magdalena Szynal
- Department of Cardiology, Faculty of Health Sciences, Medical University of Silesia in Katowice, Ziołowa Street 45-47, 40-635 Katowice, Poland; (J.D.); (Z.G.); (M.S.)
| | - Piotr Jankowski
- Department of Internal Medicine and Gerontology, Medical Center for Postgraduate Education, 01-813 Warsaw, Poland;
| | - Karol Kamiński
- Department of Population Medicine, Medical University Bialystok, M. Skłodowskiej-Curie 24A, 15-089 Bialystok, Poland
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Sisay T, Mulate M, Hailu T, Belete TM. The prevalence of depression and anxiety among cardiovascular patients at University of Gondar specialized hospital using beck's depression inventory II and beck anxiety inventory: A cross-sectional study. Heliyon 2024; 10:e24079. [PMID: 38293464 PMCID: PMC10827446 DOI: 10.1016/j.heliyon.2024.e24079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
Psychosocial issues are leading factor as well as consequences of cardiovascular disease. Identifying factors associated with depression facilitate service quality improvement for inpatients. This study assessed the prevalence and identified associated factors with depression and anxiety among patients with cardio vascular disease. Method An institution-based cross-sectional study was conducted with a convenience sample of 370 stable adult patients from June 1 to July 30, 2020 among cardiovascular disease patients at the University of Gondar Specialized Hospital Ethiopia. Data were collected by using structured questionnaires. Data analyses were conducted using SPSS version 21. The statistical significance declared at p-value <0.05. Result In this study, among 370 Cardiovascular diseases patients, 228 (61.6 %) suffer from anxiety, and 53.51 % (198) suffer with depression. There was a significant mean difference in the level of depression and anxiety between male and female Cardiovascular diseases patients. The females' scores of depression (mean = 28, p < 0.01) and anxiety (mean = 25.3, p < 0.01) were more than that of males 'scores of depression (mean = 15.1, p < 0.01) and anxiety (mean = 12.3, p < 0.01). Cardiovascular diseases patients aged greater than 60 years have the highest rate of prevalence of depression in all age group. Being in the age category of greater than 60 years was 1.16 (0.57-2.32) times more likely to have depression than the age category of 18-24 years. Depression and anxiety were significantly associated with being woman, widowed, being single, unable to read and write, and possess mental disorders history.
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Affiliation(s)
- Tihitina Sisay
- Department of Psychology, College of Social Science and Humanities, University of Gondar, Gondar, Ethiopia
| | - Missaye Mulate
- Department of Psychology, College of Social Science and Humanities, University of Gondar, Gondar, Ethiopia
| | - Tewodrose Hailu
- Department of Psychology, College of Social Science and Humanities, University of Gondar, Gondar, Ethiopia
| | - Tafere Mulaw Belete
- Department of Pharmacology, College of Medicine and Health Sciences, University of Gondar, P.o.box 196, Gondar, Ethiopia
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Effectiveness of Hypnosis for the Prevention of Anxiety During Coronary Angiography (HYPCOR study): a prospective randomized study. BMC Complement Med Ther 2022; 22:315. [PMID: 36447198 PMCID: PMC9707301 DOI: 10.1186/s12906-022-03792-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Coronary angiography is the gold standard for the diagnosis of coronary artery disease. This intervention is nevertheless a source of anxiety for the patient both by its discomfort and by the consequences linked to the discovery of potential diseases. OBJECTIVES The aim of this study was to determine the effectiveness of hypnosis in reducing anxiety in patients undergoing coronary angiography. METHODS One hundred sixty-nine patients with planned coronary angiography and no history of coronary angiography were randomized to a hypnosis or control group. Patients in the hypnosis group underwent a hypnosis session with self-hypnosis posthypnotic suggestions, while those in the control group had a conversational interview with the hypnotherapist. The primary endpoint was pre-exam anxiety level assessed by the Spielberger State-Trait Anxiety Inventory (STAI-Y A). RESULTS Performing a hypnosis session did not result in a significant decrease in anxiety before the intervention. Age, high trait anxiety, high state anxiety the day before, and belief that hypnosis works in general were associated with increased anxiety before the procedure. No adverse events were reported after hypnosis. There was no statistically significant difference between the 2 groups for the occurrence of complications of the intervention. CONCLUSION In this study, performing a hypnosis session before coronary angiography did not reduce the state of anxiety measured just before the intervention. In all cases, the hypnotic experience appears to be positive for the patient, encouraging further research efforts. TRIAL REGISTRATION The research protocol has been registered on the ClinicalTrials.gov registry (NCT02818101; 29/06/2016) and with the ANSM (IDRCB 2016-A00205-46; 02/02/2016).
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Ginting SRR, Loebis B, Camellia V. Factors Associated with Anxiety Scores in Patients with Stable Angina Pectoris in Cardiology Outpatient Clinic of Universitas Sumatera Utara Hospital. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Stable angina pectoris is of great interest to health care workers because of the high levels of anxiety observed in patients following a coronary event. This study aims to investigate factors associated with anxiety scores in patients with stable angina pectoris.
Methods: This cross-sectional study was conducted from November to December 2020. Subjects were patients diagnosed with stable angina pectoris in the Cardiology outpatient clinic of Universitas Sumatera Utara Hospital. Signed the informed consent were subjected to history taking, and structured interviews then were asked to fill out the HADS questionnaire.
Results: A total of 200 study subjects were obtained. The majority of the subjects, 110 (55%) subjects, were women. Of all subjects, 105 (52.5%) subjects were married. The majority of study subjects were employed (61.5%), had >9 years education (88%), non-smokers (70.5%), had comorbidities (73.5%) and had a family history of the disease (64%). The median age was 53 years (min 50, max 55 years). The median value of the length of illness was seven years (min 1 year, max 12 years). The median value of body mass index was 24.16 (min 20.11, max 30.59).
Conclusion: Age, marital relationship, occupation, smoking status, comorbidities, family history of the disease, and body mass index were found to be associated with anxiety scores in patients with stable angina pectoris.
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Amin MA, Ahmed M, Nahin S, Kakoly NS. Assessment of Depression and Anxiety Among Admitted People With Heart Disease Conditions: A Cross-Sectional Hospital-Based Study in a Bangladeshi Population During the COVID-19. Front Psychiatry 2022; 13:895224. [PMID: 35873273 PMCID: PMC9302201 DOI: 10.3389/fpsyt.2022.895224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Depression and anxiety are widespread and chronic among patients with heart disease. We wanted to determine the proportion of heart patients with depression and anxiety levels as well as factors contributing toward depression and anxiety among hospitalized heart disease patients in Dhaka, Bangladesh during the COVID-19 era. METHODS The study comprised a total of 384 participants with a confirmed heart disease diagnosis. We conducted a cross-sectional study from 5th March to 27th June 2021. The hospital-based study admitted patients sequentially with a new or pre-existing heart disease diagnosis to one of Dhaka's two leading hospitals. The Hospital Anxiety and Depression Scale screened all individuals for depression and anxiety. RESULT Most of the respondents (88.2%) were male and within the age categories of 51-60 years (32.81%). 96.6% of the patients were married, 30% had no income, 36.6% had only completed classes 1-5, and ~47% resided in rural areas. Approximately 36% of the study participants were former smokers, with 31% current smokers. Borderline abnormal and abnormal levels of anxiety and borderline abnormal and abnormal levels of depression were found in (23.9%, 49.4%) and (55.7%, 13.3%), respectively, of hospitalized patients. Age, residence, profession, monthly income, and chronic disease were significant predictors of anxiety, while only gender remained significantly associated with depression. CONCLUSION Hospitalized Bangladeshi patients with heart disease had moderate levels of depression and anxiety. There is a need to develop a quick screening approach in hospitals dealing with hospitalized patients with heart disease to identify those needing extra evaluation and care.
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Affiliation(s)
- Mohammad Ashraful Amin
- Department of Public Health, North South University, Dhaka, Bangladesh.,Public Health Professional Development Society (PPDS), Dhaka, Bangladesh
| | - Mohsin Ahmed
- Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
| | - Sabrina Nahin
- Department of Physiology, Green Life Medical College Hospital, Dhaka, Bangladesh
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Wang H, Ba Y, Han W, Zhang H, Zhu L, Jiang P. Association of heat shock protein polymorphisms with patient susceptibility to coronary artery disease comorbid depression and anxiety in a Chinese population. PeerJ 2021; 9:e11636. [PMID: 34178482 PMCID: PMC8216166 DOI: 10.7717/peerj.11636] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/27/2021] [Indexed: 01/03/2023] Open
Abstract
Background Coronary artery disease (CAD) is one of the severe diseases that threaten human health worldwide. In addition, the associated rate of comorbidity with depression and anxiety is extremely high. Heat shock proteins (HSPs) are a group of proteins that possesses cardiovascular and psychological protection properties. The objective of this study is to determine the association of the two most widely studied HSPs, namely, HSP70 and HSP90, with CAD comorbid depression and anxiety in a Chinese population. Methods A case-control study involving 271 CAD patients and 113 healthy individuals was conducted. The 271 CAD patients include individuals with (123) and without depression (148) and individuals with (57) and without anxiety (214). Ten single nucleotide polymorphisms (SNPs) for HSP70 and seven SNPs for HSP90 were selected and genotyped. Results Results revealed that the HSP70 rs10892958 C allele and HSP70 rs2236658 T allele were associated with a decreased risk of CAD (P < 0.05), whereas the G allele of the rs11218941 polymorphism was associated with an increased risk of CAD. The haplotype analysis results indicated that the haplotype TGGGC of the HSPA8 gene (coded the HSP70 family, rs4936770/rs4802/rs10892958/rs11218941/rs2236658) significantly increased the risk of CAD (P = 0.008). Among the patients with CAD, the carriers of the CC genotype for the HSP90 rs1042665 showed higher risks of anxiety than the carriers of another genotypes. However, no significant relationships were found among the CAD with depression and CAD without depression groups for the selected SNPs. These findings suggested that the genetic polymorphisms in the HSP gene, especially the HSPA8 of HSP70, contribute to CAD susceptibility and rs1042665 genetic polymorphisms might have an effect on the anxiety incidence among CAD patients.
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Affiliation(s)
- Haidong Wang
- Department of Pharmacy, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyungang, Lianyungang, China
| | - Yudong Ba
- Department of Pharmacy, Dongying People's Hospital, Dongying, China
| | - Wenxiu Han
- Jining First People's Hospital, Jining Medical University, Jining, China
| | - Haixia Zhang
- Jining First People's Hospital, Jining Medical University, Jining, China
| | - Laiqing Zhu
- Jining First People's Hospital, Jining Medical University, Jining, China
| | - Pei Jiang
- Jining First People's Hospital, Jining Medical University, Jining, China
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Hou Y, Zhang D, Zhu J, Zhao X, Lu M, Wu Q, Ojo O, Wang X, Zhang Y. Short report: depression and anxiety symptoms as predictors of adverse cardiovascular events in Chinese patients after percutaneous coronary intervention. PSYCHOL HEALTH MED 2020; 26:1126-1133. [PMID: 33073611 DOI: 10.1080/13548506.2020.1837388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Depression and anxiety often co-occur in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI). This study was conducted to examine the predictive value of depression, anxiety, and their combination on the prognosis of Chinese PCI patients. A multicenter prospective study was undertaken with a sample of 309 primary PCI patients. The Hospital Anxiety and Depression Scale (HADS) was completed at baseline to assess anxiety and depression symptoms. Major adverse cardiovascular events (MACEs) were recorded for 12 months after PCI . Days from baseline to the first MACE was the outcome variable. MACEs occurred in 26 (8.4%) patients. After adjustments for socio-demographic and clinical characteristics, a Cox proportional hazards regression model revealed that depression (HR = 2.70, 95% confidence interval [CI] 1.22-5.95; p =.014) and anxiety (HR = 2.56, 95% CI 1.18-5.54; p =.017) symptoms were independent predictors of MACEs. A subanalysis showed that the cumulative event-free survival curves did not differ among depressed and anxious patients and depressed but non-anxious patients (Log Rank p =.52). In conclusion, depression is associated with an increased risk for MACEs post-PCI, independent of anxiety. Although anxiety is associated with MACEs, it has no additional predictive value when co-occurring with depression.
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Affiliation(s)
- Yunying Hou
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,School of Nursing, Soochow University, Suzhou, China
| | - Dandan Zhang
- School of Nursing, Soochow University, Suzhou, China
| | - Jifang Zhu
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin Zhao
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Minxia Lu
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qing Wu
- School of Nursing, Soochow University, Suzhou, China
| | - Omorogieva Ojo
- Faculty of Education and Health, University of Greenwich Avery Hill Campus, London, UK
| | - Xiaohua Wang
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,School of Nursing, Soochow University, Suzhou, China
| | - Yonghong Zhang
- School of Public Health, Soochow University, Suzhou, China
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8
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Chen YY, Xu P, Wang Y, Song TJ, Luo N, Zhao LJ. Prevalence of and risk factors for anxiety after coronary heart disease: Systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e16973. [PMID: 31567932 PMCID: PMC6756742 DOI: 10.1097/md.0000000000016973] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND As the most important component of cardiovascular disease, coronary heart disease (CHD) is closely related to psychological factors such as anxiety. Anxiety, whether present before or after the onset of illness, can lead to many serious consequences. The aim of this systematic review and meta-analysis was to assess the prevalence of and potential risk factors for anxiety after coronary heart disease (post-CHD anxiety). METHOD Systematic searches were performed in electronic databases including China National Knowledge Infrastructure (CNKI), Wanfang, Technology Journal database (VIP), PubMed, Web of Science, Embase and Medline. RESULT Thirteen studies were included. With regard to cross-sectional studies, the prevalence of post-CHD anxiety was P = .37, 95% CI (0.26-0.49). The overall analysis among cohort studies revealed that the prevalence of post-CHD anxiety was P = .50, 95% CI (0.05-0.95). Among the 11 potential risk factors, low education level [OR = 1.46, 95% CI (1.05-2.02)] and long duration of disease [OR = 2.05, 95% CI (1.05-4.00)] were statistically significant. CONCLUSION There is high heterogeneity between studies and many defects; thus, further research is required to support these results. Attention should be paid to post-CHD anxiety, and clinical caring should include psychological counselling and imparting disease-related knowledge to patients with a long disease duration and low educational background.
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Affiliation(s)
- Ying-Ying Chen
- Department of Rehabilitation Nursing, School of Nursing, Jilin University
| | - Ping Xu
- Department of Rehabilitation Nursing, School of Nursing, Jilin University
| | - Yuan Wang
- Department of Rehabilitation Nursing, School of Nursing, Jilin University
| | - Tian-Jiao Song
- Department of Rehabilitation Nursing, School of Nursing, Jilin University
| | - Nan Luo
- Department of Cardiology, The Second Hospital of Jilin University,Changchun, Jilin, People's Republic of China
| | - Li-Jing Zhao
- Department of Rehabilitation Nursing, School of Nursing, Jilin University
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Hou Y, Zhao X, Lu M, Lei X, Wu Q, Wang X. Brief, one-on-one, telephone-adapted mindfulness-based stress reduction for patients undergoing percutaneous coronary intervention: a randomized controlled trial. Transl Behav Med 2019; 9:1216-1223. [PMID: 31504974 DOI: 10.1093/tbm/ibz130] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Patients undergoing percutaneous coronary intervention showed significant psychological symptoms improvement when assigned to a brief on-on-one, telephone-adapted mindfulness-based stress reduction intervention.
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Affiliation(s)
- Yunying Hou
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- School of Nursing, Soochow University, Suzhou, China
| | - Xin Zhao
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Minxia Lu
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoqing Lei
- School of Nursing, Soochow University, Suzhou, China
| | - Qing Wu
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- School of Nursing, Soochow University, Suzhou, China
| | - Xiaohua Wang
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- School of Nursing, Soochow University, Suzhou, China
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Vlastra W, Delewi R, Rohling WJ, Wagenaar TC, Hirsch A, Meesterman MG, Vis MM, Wykrzykowska JJ, Koch KT, de Winter RJ, Baan J, Piek JJ, Sprangers MAG, Henriques JPS. Premedication to reduce anxiety in patients undergoing coronary angiography and percutaneous coronary intervention. Open Heart 2018; 5:e000833. [PMID: 30275956 PMCID: PMC6157563 DOI: 10.1136/openhrt-2018-000833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/09/2018] [Accepted: 08/22/2018] [Indexed: 11/09/2022] Open
Abstract
Aims In this study, we examined the effects of the routinely administration of benzodiazepines on reducing periprocedural anxiety versus no premedication. Methods In this open label study, we enrolled 1683 patients undergoing diagnostic coronary angiograms (CAG) or percutaneous coronary interventions (PCI). Randomisation was simulated by systematically allocating patients in monthly rotational periods to lorazepam 1 mg/sl, oxazepam 10 mg/po, diazepam 5 mg/po, midazolam 7.5 mg/po or no premedication. Anxiety was measured at four different time points using the one-item Visual Analogue Scale for Anxiety (VAS score) ranging from 0 to 10. The primary outcome was the difference in anxiety reduction (ΔVAS, preprocedure to postprocedure), between the different premedication strategies versus no premedication. Results Anxiety reduction was larger in patients premedicated with lorazepam (ΔVAS=−2.0, SE=1.6, P=0.007) or diazepam (ΔVAS=−2.0, SE=1.5, p=0.003) compared with patients without any premedication (ΔVAS=−1.4, SE=1.2). The use of midazolam or oxazepam did not lead to a significant reduction in anxiety compared with patients who did not receive premedication. Additionally, a high number of patients treated with midazolam (N=39, 19.8%) developed side effects. Conclusions In this study, the use of lorazepam or diazepam was associated with a significant, but modest anxiety reduction in patients undergoing CAG or PCI. This study does not support the standard use of oxazepam or midazolam as premedication to reduce anxiety.
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Affiliation(s)
- Wieneke Vlastra
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Ronak Delewi
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Wim J Rohling
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Tineke C Wagenaar
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Alexander Hirsch
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Martin G Meesterman
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Marije M Vis
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Joanna J Wykrzykowska
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Karel T Koch
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Robbert J de Winter
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jan Baan
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jan J Piek
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - José P S Henriques
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
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Abstract
The analytical paper summarized the results of recent studies of an association of depression, anxiety, and stress with coronary heart disease (CHD). Mental disorders are shown to be associated with increased risk of CHD and to worsen the course of coronary disease. Antidepressants and psychotherapy improve the control of mental disorders, quality of life, and, in some cases, have a positive impact on the course of coronary disease.
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Jayakar JP, Alter DA. Music for anxiety reduction in patients undergoing cardiac catheterization: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract 2017; 28:122-130. [PMID: 28779919 DOI: 10.1016/j.ctcp.2017.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/23/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Medical diagnostic procedures, such as cardiac catheterization, can cause significant patient anxiety. Patient anxiety can have negative implications for compliance with healthcare visits, medical tests, and treatments. Music interventions may have a role in reducing anxiety related to cardiac catheterization procedures. OBJECTIVE To perform a comprehensive systematic review and meta-analysis evaluating whether musical interventions reduce anxiety in patients undergoing cardiac catheterization. DATA SOURCES MEDLINE, EMBASE, CENTRAL, AMED, and PsychINFO from inception to May 2015. Reference lists of included articles were further hand searched for additional eligible studies. STUDY SELECTION Randomized controlled trials evaluating the effectiveness of music interventions for anxiety reduction in patients undergoing cardiac catheterization. DATA EXTRACTION AND SYNTHESIS Data on trial design, baseline characteristics and outcomes was extracted using a data extraction table. Study quality and risk of bias were assessed using the JADAD scale. MAIN OUTCOMES AND MEASURES The main outcome was the effectiveness of music interventions in reducing anxiety in this patient population. Meta-analysis was pursued using data from studies that had used the Spielberger state anxiety inventory (STAI-S) to measure anxiety reduction. Other outcomes qualitatively reported include the use of anxiolytic medications and effect on physiological parameters such as blood pressure and heart rate. RESULTS A total of 15 studies were found to be eligible for inclusion (14 published trials and one conference abstract) in this review. Two-thirds of these studies showed statistically significant reduction in measures of patient anxiety or well-being with musical interventions. Meta-analysis included six studies (n = 695) and showed statistically significant reduction in mean STAI-S scores with music (-3.95 points; 95% confidence -5.53 and -2.37; p value less than 0.005). CONCLUSION AND RELEVANCE In conclusion, music is a safe and easily administered intervention that can be used for anxiety reduction among patients undergoing cardiac catheterization. Further research is needed to better evaluate the clinical implications associated with the anxiolytic effects of music interventions during cardiac catheterization.
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Affiliation(s)
- Jai P Jayakar
- Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David A Alter
- University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada; The Institute for Clinical Evaluative Sciences of Ontario, Toronto, Ontario, Canada.
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Pan XF, Meng R, Liu N, Pan A. Depression, Anxiety, and Cardiovascular Disease in Chinese: A Review for a Bigger Picture. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2017. [DOI: 10.15212/cvia.2016.0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Anxiety levels of patients undergoing coronary procedures in the catheterization laboratory. Int J Cardiol 2016; 228:926-930. [PMID: 27912201 DOI: 10.1016/j.ijcard.2016.11.043] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/07/2016] [Accepted: 11/05/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND High levels of anxiety are associated with worse outcomes in coronary artery disease patients. Little is known about anxiety levels in patients undergoing coronary procedures. Our objective is to examine the levels of anxiety in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) during the different phases of hospital stay and to evaluate which patient characteristics are associated with increased anxiety. METHODS Patients undergoing CAG or PCI between April 2009 and April 2010 were included in this prospective cohort study. Anxiety levels were measured using the self reported Visual Analogue Scale (VAS) of Anxiety, ranging from 0 to 100. VAS anxiety scores were obtained at hospital intake, pre- and post-procedure, and at hospital discharge. Multivariate linear regression analyses were performed to assess correlations between baseline characteristics and anxiety levels at the different time points. RESULTS In total 2604 patients were included, with 70.4% male participants with a mean age of 65±12years. VAS anxiety scores were highest pre-procedure (44.2±27.0mm). Female patients reported a significantly higher pre procedure VAS anxiety score (50.4±26.5) compared to males (41.5±26.8, p=0.02). Other factors associated with higher levels of anxiety at different time points were age<65years, low level of education and an acute primary PCI. CONCLUSION In the largest cohort to date, we examined anxiety among patients undergoing PCI or CAG was highest immediately around the procedure, particularly in patients aged <65years, of female gender, undergoing primary PCI, or with a lower level of education. Better pre-procedural information or pharmacological strategies may reduce anxiety in these patients.
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Miloyan B, Bulley A, Bandeen-Roche K, Eaton WW, Gonçalves-Bradley DC. Anxiety disorders and all-cause mortality: systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1467-1475. [PMID: 27628244 PMCID: PMC5102798 DOI: 10.1007/s00127-016-1284-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/07/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE The purpose of this study was to perform a systematic review and meta-analysis of prospective cohort studies that examined the relationship between anxiety disorders, or clinically significant anxiety symptoms, at baseline and all-cause mortality at follow-up relative to control participants without clinically significant anxiety. METHODS PubMed, EMBASE, PsycInfo, and CINAHL were searched through July 2015, along with manual searches of published reviews and forward and backward snowball searches of included studies. Studies were excluded if anxiety was not defined with a standardized instrument, or if participants were followed-up for 1 year or less. The initial search yielded 7901 articles after the removal of duplicates, of which 328 underwent full-text screening. RESULTS Forty-two estimates from 36 articles were included in the meta-analysis with a total sample of 127,552 participants and over 11,573 deaths. The overall hazard ratio (HR) estimate of mortality in clinically anxious participants relative to controls was 1.09 (95 % CI 1.01-1.16); however, this was reduced after adjusting for publication bias (1.03; 95 % CI 0.95-1.13). There was no evidence of increased mortality risk among anxious participants derived from community samples (0.99; 95 % CI 0.96-1.02) and in studies that adjusted for a diagnosis of depression (1.01; 95 % CI 0.96-1.06). CONCLUSIONS These findings suggest that positive associations in the literature are attributable to studies in smaller samples, comorbid depression (or other psychiatric conditions) among participants, and possible confounding in medical patient samples followed-up for short durations.
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Affiliation(s)
- Beyon Miloyan
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Adam Bulley
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Karen Bandeen-Roche
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - William W Eaton
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Depression and anxiety as predictors of recurrent cardiac events 12 months after percutaneous coronary interventions. J Cardiovasc Nurs 2016; 30:351-9. [PMID: 24763357 DOI: 10.1097/jcn.0000000000000143] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Anxiety and depression are associated with recurrent cardiac events after percutaneous coronary interventions (PCIs). However, few investigators have evaluated the impact of depression and anxiety on recurrent cardiac events in Korea. OBJECTIVE The aim of this study was to examine the relationship among depression, anxiety, and recurrent cardiac events in Korean patients with coronary artery disease (CAD) after PCI. METHODS A prospective longitudinal study was undertaken with a sample of 133 CAD patients with PCI. Data were collected between August 2009 and September 2010, and patients were followed after discharge through 2011 with self-report questionnaires on anxiety and depression using the Hospital Anxiety and Depression Scale and with patient medical records on sociodemographic and clinical characteristics. Recurrent cardiac events were collected for 12 months after discharge and were assessed by patient interviews and medical records. RESULTS There were 18 recurrent cardiac events (13.5%) among the 133 participants. After adjustment for sociodemographic and clinical characteristics, a hierarchical Cox proportional hazards regression model found that a moderate or severe level of anxiety (hazard ratio, 6.21; 95% confidence interval, 1.64-23.54) and a moderate or severe level of depression (hazard ratio, 4.32; 95% confidence interval, 1.35-13.88) were independent predictors of recurrent cardiac events. CONCLUSIONS Patients with CAD who have a high level of anxiety and depression are at increased risk for recurrent cardiac events after PCI. Screening should be focused on patients who experience anxious and depressive feelings in addition to traditional risk factors. Furthermore, psychoeducational support interventions to reduce anxiety and depression after PCI may improve health outcomes.
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Celano CM, Millstein RA, Bedoya CA, Healy BC, Roest AM, Huffman JC. Association between anxiety and mortality in patients with coronary artery disease: A meta-analysis. Am Heart J 2015; 170:1105-15. [PMID: 26678632 DOI: 10.1016/j.ahj.2015.09.013] [Citation(s) in RCA: 167] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/11/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression and anxiety are common in patients with coronary artery disease (CAD). Although depression clearly has been associated with mortality in this population, the relationship between anxiety and mortality is less clear. Accordingly, we performed a series of meta-analyses to (1) examine the relationship between anxiety and mortality in patients with established CAD and (2) determine if this relationship differs in patients with stable CAD compared to those who have just had an acute coronary syndrome (ACS). METHODS AND RESULTS Systematic literature searches identified 44 articles (total N = 30,527) evaluating the prospective relationship between anxiety and mortality in individuals with established CAD. A series of 8 adjusted and unadjusted meta-analyses were performed to examine this relationship across all patients, with sensitivity analyses completed in post-ACS and stable CAD cohorts. In unadjusted analyses, anxiety was associated with a moderate increase in mortality risk (odds ratio 1.21 per SD increase in anxiety). However, when adjusting for covariates, nearly all associations became nonsignificant. In sensitivity analyses, anxiety was associated with an increased risk of poor outcomes in the stable CAD-but not post-ACS-cohort. CONCLUSIONS These analyses confirm that anxiety is associated with increased risk of mortality in patients with CAD; however, this relationship is not as strong as that of depression and may be explained partly by other clinical factors. If anxiety screening is performed, it should be performed during a period of clinical stability and should target anxiety disorders rather than anxiety symptoms alone.
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Affiliation(s)
- Christopher M Celano
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
| | - Rachel A Millstein
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - C Andres Bedoya
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Brian C Healy
- Harvard Medical School, Boston, MA; Department of Neurology, Massachusetts General Hospital, Boston, MA
| | - Annelieke M Roest
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Department of Neurology, Massachusetts General Hospital, Boston, MA
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Severity of Depression, Anxious Distress and the Risk of Cardiovascular Disease in a Swedish Population-Based Cohort. PLoS One 2015; 10:e0140742. [PMID: 26469703 PMCID: PMC4607409 DOI: 10.1371/journal.pone.0140742] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 09/30/2015] [Indexed: 12/30/2022] Open
Abstract
Background Depression is known to be associated with cardiovascular diseases (CVD). This population-based cohort study aimed to determine the association between depression of varying severity and risk for CVD and to study the effect of concomitant anxious distress on this association. Methods We utilized data from a longitudinal cohort study of mental health, work and relations among adults (20–64 years), with a total of 10,443 individuals. Depression and anxious distress were assessed using psychiatric rating scales and defined according to DSM-5. Outcomes were register-based and self-reported cardiovascular diseases. Findings Overall increased odds ratios of 1.5 to 2.6 were seen for the different severity levels of depression, with the highest adjusted OR for moderate depression (OR 2.1 (95% CI 1.3, 3.5). Similar odds ratios were seen for sub-groups of CVD: ischemic/hypertensive heart disease and stroke, 2.4 (95% CI 1.4, 3.9) and OR 2.1 (95%CI 1.2, 3.8) respectively. Depression with anxious distress as a specifier of severity showed OR of 2.1 (95% CI 1.5, 2.9) for CVD. Conclusion This study found that severity level of depression seems to be of significance for increased risk of CVD among depressed persons, although not in a dose-response manner which might be obscured due to treatment of depression. Further, we found a higher risk of CVD among depressed individuals with symptoms of anxious distress.
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Young QR, Nguyen M, Roth S, Broadberry A, Mackay MH. Single-item measures for depression and anxiety: Validation of the Screening Tool for Psychological Distress in an inpatient cardiology setting. Eur J Cardiovasc Nurs 2014; 14:544-51. [DOI: 10.1177/1474515114548649] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 07/28/2014] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Susan Roth
- Heart Centre, St. Paul’s Hospital, Canada
| | | | - Martha H Mackay
- Heart Centre, St. Paul’s Hospital, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul’s Hospital, Canada
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