Mental illness and obesity among Veterans undergoing percutaneous coronary intervention: Insights from the VA CART program

Influencing factors of care dependence in patients with coronary heart disease after percutaneous coronary intervention-A cross-sectional study

AIM

Care dependence has been scarcely investigated in coronary heart disease patients after percutaneous coronary intervention. This study aimed to investigate the association between frailty, self-efficacy, combined effects of frailty and self-efficacy, mental health, and care dependence in coronary heart disease patients after percutaneous coronary intervention.

DESIGN

Cross-sectional study.

METHODS

Data from 400 patients after percutaneous coronary intervention were collected from 2017-2020. Logistic regression model and mediating analysis were used to identify the association between frailty, self-efficacy, combined effects of frailty and self-efficacy, and care dependence.

RESULTS

Patients with frailty and self-efficacy tended to have severe care dependence symptoms. There was no correlation between frailty symptoms, self-efficacy, and care dependence in patients without symptoms of anxiety or depression. But in patients with anxiety or depression symptoms, there is a strong correlation between frailty symptoms, lower self-efficacy, and care dependence. Mental health played an inhibitory effect on frailty and care dependence.

The effects of a comprehensive rehabilitation and intensive education program on anxiety, depression, quality of life, and major adverse cardiac and cerebrovascular events in unprotected left main coronary artery disease patients who underwent coronary artery bypass grafting

OBJECTIVE

This study aimed to explore the effect of a comprehensive rehabilitation and intensive education (CRIE) program on anxiety, depression, quality of life (QoL), and major adverse cardiac and cerebrovascular events (MACCE) risk in unprotected left main coronary artery disease (ULMCAD) patients who underwent coronary artery bypass grafting (CABG).

METHODS

In total, 300 ULMCAD patients who underwent CABG were randomly assigned to the CRIE group or usual care (UC) group in a 1:1 ratio. During a 12-month intervention, anxiety and depression were evaluated by Hospital Anxiety and Depression Scale (HADS), QoL was evaluated by 12-Item Short-Form Health Survey (SF-12), on discharge day from hospital (M0), and at 3 months after the discharge (M3), M6, and M12. All patients were further followed up until occurrence of MACCE or for an additional 24 months, and MACCE accumulating occurrence rate was calculated.

RESULTS

At M12, HADS-anxiety score and anxiety prevalence (17.3% vs. 29.3%) were decreased in the CRIE group than those in the UC group, meanwhile HADS-depression score and depression prevalence (15.3% vs. 24.7%) were also reduced in the CRIE group than those in the UC group. For QoL, SF-12 Physical Component Summary (PCS) score at M6/M12, and SF-12 PCS score change (M12 - M0) were increased in the CRIE group than those in the UC group; meanwhile, SF-12 Mental Component Summary (MCS) score at M12 and SF-12 PCS score change (M12 - M0) were increased in the CRIE group than those in the UC group as well. Besides, MACCE accumulating occurrence rate was numerically lower in the CRIE group compared with that in the UC group but without statistical significance.

CONCLUSIONS

CRIE is an effective approach in improving anxiety, depression, and QoL in ULMCAD patients who underwent CABG.