scholarly journals Prevalence of Cardiac Depression and its Related Factors among Patients with Acute Coronary Syndrome

Author(s):  
Amir Hossein Goudarzian ◽  
Hamid Sharif Nia ◽  
Heydar Tavakoli ◽  
Mohammad Ali Soleimani ◽  
Ameneh Yaghoobzadeh ◽  
...  

Cardiac depression is one of the most common psychological reactions of patients with acute coronary syndrome (ACS). This study aimed to determine the prevalence of cardiac depression and its related factors among patients with ACS. This cross-sectional study was conducted during 2016 in patients with ACS who were admitted to hospitals affiliated to the Mazandaran University of Medical Sciences, Iran. In the present study, 407 patients completed the Cardiac Depression Scale (CDS) within two months (March - June). The data were analyzed by a chi-square test and a general linear model multivariate analysis. According to the results, the mean cardiac depression score in patients with ACS was 109.00 ± 16.49 (CI95: 107.39 to 110.60). Among the participants, 37 (9.1%), 72 (17.7%), and 298 (73.2%) patients had mild, moderate, and severe levels of depression, respectively. Although the two-way ANOVA was not significant, but there was a difference between cardiac depression score of a type of ACS. Given the high prevalence of cardiac depression among these patients, it is necessary to develop measures for routine screening in cardiac treatment units.

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J H C Smith ◽  
S Toukhsati ◽  
A J P Francis ◽  
V Stavropoulos ◽  
D L Hare

Abstract Background Depression is common in patients following an Acute Coronary Syndrome (ACS) substantially increases the risk of future events and mortality. Post-ACS depression typically resembles one of four longitudinal trajectories: chronic; absent; recovered, or delayed depression. Early identification of a patient's post-ACS depression trajectory will improve risk stratification, treatment implementation and risk management. Purpose To explore whether stable psychosocial traits, such as resilience, predict the trajectory of depression one month and 6 months following an ACS admission. Method Consecutive adult ACS patients (STEMI/NSTEMI) admitted to a large general hospital completed the Cardiac Depression Scale (CDS) and the Sense of Coherence scale during their admission, then one and six months following discharge. Results 132 ACS in-patients (males = 111; mean age = 63.13±13.47) satisfied enrolment criteria. Unconditional linear latent growth modelling identified a 3-class model for the trajectory of depression post-ACS (increasing depression; consistent non-depressed; decreasing non-depressed). For the increasing depression class, resilience at baseline was significant and negative compared to the consistent class, b=−0.06, Wald chi square (1) = 4.42, p=0.036 and the decreasing class, b=−0.09, Wald chi square (1) = 7.20, p=0.007. Conclusions Patients who reported lower levels of resilience during an ACS admission were significantly more likely to experience initially high levels of depressive symptoms (CDS ≥85) that exceeded the clinically relevant cut-off (CDS ≥95) at 6 months post-discharge. This study suggests that screening for resilience and depression will improve risk stratification for persistent and delayed depression post-ACS.


2019 ◽  
Vol 17 (4) ◽  
pp. 131-143 ◽  
Author(s):  
Muhammad Marwat ◽  
Iftikhar Ahmad ◽  
Fariha Ashiq ◽  
Sania Ali ◽  
Sher Zamir ◽  
...  

Background: Global Health Estimates 2015 has shown IHD as second leading global cause of death and 3rd leading global cause for DALYs for 2015. The objectives of this study were to determine frequency, distribution and determinants of DM in adult acute coronary syndrome (ACS) population of D.I.Khan Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in Departments of Ophthalmology & Community Medicine, Gomal Medical College, D.I.Khan, from February 1, 2017 to April 30, 2017. 331 cases were selected with margin of error 4.511%, 90%CL and 25% prevalence of DM in 73,438 adults assumed to have IHD. All indoor adult patients of ACS were eligible. Sex, age groups, and residence and presence of DM were variables. Frequency and distribution were analyzed by count and percentage. Hypotheses for distribution were substantiated by chi-square goodness-of-fit and of association by chi-square test of association. Results: Out of 331 patients with ACS, 225 (68.0%) were men and 106 (32.0%) women, 221 (66.8%) ≤60 years and 110 (33.2%) >60 years, and 210 (63.4%) urban and 121 (35.6%) rural. Frequency of DM was 79/331 (23.87%). Out of 79 patients with DM, men were 44 (13.29%), women 35 (10.57%), age group ≤60 years 57 (17.22%), >60 years 22 (6.65%), urban 53 (16.01%) and rural 60 (7.85%). Our prevalence of DM was lower than expected (p=.00214), our distribution by sex was similar to expected (p=.4993) while our distribution for age groups (p=.01209) and residence (p=.00005) were not similar to expected. Presence of DM was associated to sex (p=.011) but not to age groups (p=.0304) and residence (p=.5241). Conclusion: Prevalence of DM in adult ACS population of D.I.Khan Division, Pakistan was found lower than expected. The prevalence was more in men than women, more in younger age group (≤60 years) than older age group (>60 years) and more in urban than rural population. Our prevalence of DM was lower than expected, our distribution by sex was similar to expected while our distribution for age groups and residence were not similar to expected. The presence of DM was associated to sex but not to age groups and residence.


2021 ◽  
pp. 105477382110401
Author(s):  
Audai A. Hayajneh ◽  
Mohammad Rababa ◽  
Sami Al-Rawashedeh

The prevalence of prehospital delay is high among older adults with acute coronary syndrome (ACS). The current study aimed to examine the associated factors of prehospital delay among patients with ACS during the COVID-19 pandemic. This cross-sectional study was conducted on a convenience sample of 300 older adults with ACS admitted to the emergency department in Jordan. Data were collected from June 1 to September 1, 2020. Bivariate and multivariate analyses were used to explore the predictors of prehospital delay. Being widowed, educational level, pain intensity, the gradual onset of ACS symptoms, symptoms lasting for more than 30 minutes, patients’ feeling anxious about their ACS symptoms, patients’ perceiving their symptoms to be particularly dangerous, history of myocardial infarction (MI), and mode of transportation were associated with the time taken before seeking emergency care. Significant predictors of time to seek help were chief complaint of chest pain or palpitations, abrupt onset of symptoms, the associated symptom of vertigo, and a higher number of chronic illnesses; they explained about 17.9% of the variance in the time to seek care. The average time to seek care among patients with ACS during the COVID-19 pandemic was found to be longer than the average time reported by studies conducted prior the pandemic. Improved understanding of the associations between prehospital delay is crucial for optimal ACS patient outcomes under the impacts of the COVID-19 pandemic.


2021 ◽  
pp. 39-40
Author(s):  
Avtar Singh Dhanju ◽  
Deepshikha Singla ◽  
Pashaura Singh ◽  
Ajay Chhabra ◽  
Sukhraj Kaur

Aim: The present study was undertaken with the aim to evaluate serum Gamma Glutamyl Transferase (GGT) levels in patients of acute coronary syndrome. Methodology: This cross-sectional study was conducted on 50 cases with acute coronary syndrome (Group A) and 50 healthy control subjects (Group B) meeting inclusion and exclusion criteria. Results: There is signicant rise in serum GGT levels in patients presenting with ACS in Group A as compared to Group B. Conclusion: Higher levels of GGT in ACS patients with risk factors such as hypertension, dyslipidemia and smoking may serve as biomarker to predict the occurrence of ACS.


2020 ◽  
Vol 37 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Loes T Wouters ◽  
Dorien L Zwart ◽  
Daphne C Erkelens ◽  
Noël S Cheung ◽  
Esther de Groot ◽  
...  

Abstract Background During telephone triage, it is difficult to assign adequate urgency to patients with chest discomfort. Considering the time of calling could be helpful. Objective To assess the risk of acute coronary syndrome (ACS) in certain time periods and whether sex influences this risk. Methods Cross-sectional study of 1655 recordings of telephone conversations of patients who called the out-of-hours services primary care (OHS-PC) for chest discomfort. Call time, patient characteristics, symptoms, medical history and urgency allocation of the triage conversations were collected. The final diagnosis of each call was retrieved at the patient’s general practice. Absolute numbers of patients with and without ACS were plotted and risks per hour were calculated. The risk ratio of ACS at night (0 to 9 am) was calculated by comparing to the risk at other hours and was adjusted for gender and age. Results The mean age of callers was 58.9 (standard deviation ±19.5) years, 55.5% were women and, in total, 199 (12.0%) had an ACS. The crude risk ratio for an ACS at night was 1.80 (confidence interval 1.39–2.34, P < 0.001): 2.33 (1.68–3.22, P < 0.001) for men and 1.29 (0.83–1.99, P = 0.256) for women. The adjusted risk ratio for ACS of all people at night was 1.82 (1.07–3.10, P = 0.039). Conclusions Patients calling the OHS-PC for chest discomfort between 0 and 9 am have almost twice a higher risk of ACS than those calling other hours, a phenomenon more evident in men than in women. At night, dispatching ambulances more ‘straightaway’ could be considered for these patients with chest discomfort. Trial number NTR7331.


Angiology ◽  
2016 ◽  
Vol 68 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Ahmet Göktuğ Ertem ◽  
Tolga Han Efe ◽  
Çağrı Yayla ◽  
Mehmet Kadri Akboğa ◽  
Burak Açar ◽  
...  

The SYNTAX score (SX score) is a useful score for assessing the severity of coronary artery disease (CAD). Previous studies have demonstrated a close relationship between SX score and inflammation. Procalcitonin (PCT) is an early inflammatory marker, especially during sepsis. Thus, in this study, we aimed to investigate the relationship between SX score and serum PCT levels. A total of 545 patients were enrolled in this prospective cross-sectional study and were divided into 2 subgroups, according to their SX score. Serum PCT and high-sensitivity C-reactive protein levels were measured. Serum PCT levels were higher in the high SX score group compared to the low–intermediate SX score group ( P < .001). Serum PCT levels were an independent predictor of a high SX score in patients with acute coronary syndrome ( P = .001). As patients with a higher SX score had increased serum PCT levels on admission, serum PCT may be useful for identifying patients with severe CAD.


2018 ◽  
Vol 21 (1) ◽  
pp. 70-78
Author(s):  
Taysi Seemann ◽  
Fernanda Pozzobom ◽  
Melissa de Carvalho Souza Vieira ◽  
Leonessa Boing ◽  
Zenite Machado ◽  
...  

Abstract Objective: to evaluate the prevalence of symptoms of depression among men diagnosed with prostate cancer and their association with quality of life and treatment-related factors. Methods: a cross-sectional study of 85 men with a mean age of 66±8 years who were diagnosed with prostate cancer was performed. The survey was based on a questionnaire with previously validated instruments which investigated social, demographic and economic characteristics, the history of the disease, quality of life (European Organization for Research and Treatment of Cancer Questionnaire C30 - EORTC QLQ-C30 / QLQ-PR25) and symptoms of depression (Beck Depression Inventory). The presence of symptoms of depression was considered an outcome, and statistical analyzes were performed using the Chi-square test, Fisher's exact test, Mann Whitney U test and Poisson regression (p<0.05). Results: significant results were found for quality of life in relation to symptoms of depression in the functional, global and symptomatic health scale (p<0.001). This demonstrates that the presence of symptoms of depression is related to a negative quality of life. Conclusions: for a greater understanding of prostate cancer and its consequences on the quality of life of patients it is important to consider possible disorders in psychological aspects caused by the illness, as symptoms of depression are frequent in patients undergoing treatment for prostate cancer.


Author(s):  
Christina Ann George ◽  
Shibu Thadathil Sreedharan ◽  
Smitha Kalarikkal Satheesan ◽  
Sindhu Panakkaparambil Surendranath

Introduction: Ischaemic Heart Diseases (IHD) are increasing at an alarming rate globally. Pharmacotherapy, the mainstay of management of IHD, has Dual Antiplatelet Therapy (DAPT) at its crux. DAPT, comprising of clopidogrel and aspirin, is used often for 12 months in medically managed Acute Coronary Syndrome (ACS). Clopidogrel being a prodrug, needs to be activated after ingestion, mainly by Cytochrome family of enzymes, for the desired pharmacological effects. Abnormal enzymes that convert clopidogrel to its active form can reduce the effectiveness of the drug. Therefore, Single Nucleotide Polymorphisms (SNPs) of the enzymes involved, would predispose the patient to therapy failure and recurrence of the illness. This study aims at identifying the presence of a genetic variant associated with clopidogrel responsiveness in patients with ACS. Aim: To estimate the frequency of CYP2C19*2 allele in patients with ACS presenting to Government Medical College, Thrissur, Kerala, India. Materials and Methods: Present study was a cross-sectional study done among 60 patients who presented to Government Medical College, Thrissur with ACS, between June 2018 to June 2019. Having obtained informed consent from the participants blood samples were collected in Ethylene diamine tetra-acetic Acid (EDTA) tubes. Samples were used to look for presence of CYP2C19*2 allele by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). Results: Out of 60 patients 38 were males and 22 were females. Most common age group was 61-65 years. The frequency of CYP2C19*2 allele was 41% in the study population and the variant genotype (AA/AG) was present in 62%. Conclusion: The variant genotype was found to be present in a high frequency in the study population implying the high risk for therapy failure in the study population. This asserts the need to probe the matter further, as the gene is also implicated in the metabolism of several other drugs. The introduction of pharmacogenomic testing prior to initiation of therapy may be therefore recommended for better treatment outcome. However, to validate the same, further studies with larger sample size may be necessary.


Author(s):  
Wan Nor Asyikeen Wan Adnan ◽  
Siti Azrin Ab Hamid ◽  
Zatul Rathiah Sulong ◽  
Mohd Hashairi Fauzi

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.


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