Abstract

Research Article

An observational study of the occurrence of anxiety, depression and self-reported quality of life 2 years after myocardial infarction

Catrin Henriksson, Mona-Lisa Wernroth, Christina Christersson and Christina Christersson*

Published: 17 October, 2018 | Volume 3 - Issue 3 | Pages: 052-063

Background: Patients with myocardial infarction (MI) often experience anxiety, depression and poor quality of life (QoL) compared with a normative population. Mood disturbances and QoL have been extensively investigated, but only a few studies have examined the long-term effects of MI on these complex phenomena.

Aims: To examine the levels and associated predictors of anxiety, depression, and QoL in patients 2 years after MI.

Methods: This was a single center, observational study of patients with MI (n=377, 22% women, median age 66 years). Two years after MI (2012-2014), the patients were asked to answer the Hospital Anxiety and Depression Scale (HADS) and EuroQol 5-dimension (EQ-5D-3L) questionnaires.

Results: Most patients experienced neither anxiety (87%, 95% confidence interval [CI]: 83-90%) nor depression (94%, 95% CI: 92-97%) 2 years post-MI. Elderly patients experienced more depression than younger patients (p=0.003) and women had higher anxiety levels than men (p=0.009).

Most patients had “no problems” with any of the EQ-5D-3L dimensions (72-98%), but 48% (95% CI: 43%-53%) self-reported at least “some problems” with pain/discomfort. In a multiple logistic regression model (EQ-5D-3L) higher age (p<0.001) and female sex (p<0.001) were associated with more pain/discomfort. Female sex (p=0.047) and prior MI (p=0.038) were associated with anxiety/depression. History of heart failure was associated with worse mobility (p=0.005) and problems with usual activities (p=0.006). The median total health status of the patients (EQ-VAS) was 78 (95% CI: 75-80)

Read Full Article HTML DOI: 10.29328/journal.jccm.1001027 Cite this Article Read Full Article PDF

Keywords:

Myocardial infarction; Quality of life; Anxiety and depression

References

  1. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380: 2197-2223. Ref.: https://goo.gl/bnu2pf
  2. Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, et al. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016; 37: 3232-3245. Ref.: https://goo.gl/od7AUP
  3. Kubzansky LD, Kawachi I. Going to the heart of the matter: do negative emotions cause coronary heart disease? J Psychosom Res. 2000; 48: 323-337. Ref.: https://goo.gl/gg64vi
  4. Lett HS, Blumenthal JA, Babyak MA, Sherwood A, Strauman T, et al. Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosom Med. 2004; 66: 305-315. Ref.: https://goo.gl/EyfNV5
  5. Roest AM, Zuidersma M, de Jonge P. Myocardial infarction and generalised anxiety disorder: 10-year follow-up. Br J Psychiatry. 2012; 200: 324-329. Ref.: https://goo.gl/SrFvCK
  6. Hare DL, Toukhsati SR, Johansson P, Jaarsma T. Depression and cardiovascular disease: a clinical review. Eur Heart J. 2014; 35: 1365-1372. Ref.: https://goo.gl/9KzBpZ
  7. Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014; 129: 1350-1369. Ref.: https://goo.gl/VHNSgv
  8. Watkins LL, Koch GG, Sherwood A, Blumenthal JA, Davidson JR, et al. Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease. J Am Heart Assoc. 2013; 2: e000068. Ref.: https://goo.gl/jVtsXg
  9. Moser DK, Dracup K, McKinley S, Yamasaki K, Kim CJ, et al. An international perspective on gender differences in anxiety early after acute myocardial infarction. Psychosom Med. 2003; 65: 511-516. Ref.: https://goo.gl/qauiKu
  10. Moser DK, Riegel B, McKinley S, Doering LV, An K, et al. Impact of anxiety and perceived control on in-hospital complications after acute myocardial infarction. Psychosom Med. 2007; 69: 10-16. Ref.: https://goo.gl/Qub3TH
  11. Strik JJ, Denollet J, Lousberg R, Honig A. Comparing symptoms of depression and anxiety as predictors of cardiac events and increased health care consumption after myocardial infarction. J Am Coll Cardiol. 2003; 42: 1801-1807. Ref.: https://goo.gl/PDgyRX
  12. von Kanel R. Platelet hyperactivity in clinical depression and the beneficial effect of antidepressant drug treatment: how strong is the evidence? Acta Psychiatr Scand. 2004; 110: 163-177. Ref.: https://goo.gl/44cFce
  13. Sherwood A, Hinderliter AL, Watkins LL, Waugh RA, Blumenthal JA. Impaired endothelial function in coronary heart disease patients with depressive symptomatology. J Am Coll Cardiol. 2005; 46: 656-659. Ref.: https://goo.gl/2jcL24
  14. Miller NH. Adherence behavior in the prevention and treatment of cardiovascular disease. J Cardiopulm Rehabil Prev. 2012; 32: 63-70. Ref.: https://goo.gl/cKAyFo
  15. Simpson E, Pilote L. Quality of life after acute myocardial infarction: a systematic review. Can J Cardiol. 2003; 19: 507-511. Ref.: https://goo.gl/R22HAL
  16. Mollon L, Bhattacharjee S. Health related quality of life among myocardial infarction survivors in the United States: a propensity score matched analysis. Health Qual Life Outcomes. 2017; 15: 235. Ref.: https://goo.gl/MgDJvQ
  17. Kang K, Gholizadeh L, Inglis SC, Han HR Correlates of health-related quality of life in patients with myocardial infarction: A literature review. Int J Nurs Stud. 2017; 73: 1-16. Ref.: https://goo.gl/dZiYWB
  18. Perers E, From Attebring M, Caidahl K, Herlitz J, Karlsson T, et al. Low risk is associated with poorer quality of life than high risk following acute coronary syndrome. Coron Artery Dis. 2006; 17: 501-510. Ref.: https://goo.gl/BT1fcX
  19. de Jonge P, Spijkerman TA, van den Brink RH, Ormel J. Depression after myocardial infarction is a risk factor for declining health related quality of life and increased disability and cardiac complaints at 12 months. Heart. 2006; 92: 32-39. Ref.: https://goo.gl/c1sYra
  20. Parashar S, Rumsfeld JS, Spertus JA, Reid KJ, Wenger NK. et al. Time course of depression and outcome of myocardial infarction. Arch Intern Med. 2006; 166: 2035-2043. Ref.: https://goo.gl/X6cX47
  21. Norris CM, Hegadoren K, Pilote L. Depression symptoms have a greater impact on the 1-year health-related quality of life outcomes of women post-myocardial infarction compared to men. Eur J Cardiovasc Nurs. 2007; 6: 92-98. Ref.: https://goo.gl/aWuh72
  22. van Beek MH, Mingels M, Voshaar RC, van Balkom AJ, Lappenschaar M, et al. One-year follow up of cardiac anxiety after a myocardial infarction: a latent class analysis. J Psychosom Res. 2012; 73: 362-368. Ref.: https://goo.gl/UgFQuW
  23. Christersson C, Lindahl B, Berglund L, Siegbahn A, Oldgren J. et al. The utility of coagulation activity for prediction of risk of mortality and cardiovascular events in guideline-treated myocardial infarction patients. Ups J Med Sci. 2017; 122: 224-233. Ref.: https://goo.gl/2oULPv
  24. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002; 52: 69-77. Ref.: https://goo.gl/g2enya
  25. Ellis JJ, Eagle KA, Kline-Rogers EM, Erickson SR. Validation of the EQ-5D in patients with a history of acute coronary syndrome. Curr Med Res Opin. 2005; 21: 1209-1216. Ref.: https://goo.gl/uuLHza
  26. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67: 361-370. Ref.: https://goo.gl/x9XgCS
  27. Bell ML, Fairclough DL, Fiero MH, Butow PN. Handling missing items in the Hospital Anxiety and Depression Scale (HADS): a simulation study. BMC Res Notes. 2016; 9: 479. Ref.: https://goo.gl/4crmX9
  28. Szende A, Janssen B, Cabasés JM, EuroQol G. Self-reported population health: an international perspective based on EQ-5D (2014 ed.) 2014; Dordrecht: Springer. Ref.: https://goo.gl/B3sMHy
  29. Hanssen TA, Nordrehaug JE, Eide GE, Bjelland I, Rokne B. Anxiety and depression after acute myocardial infarction: an 18-month follow-up study with repeated measures and comparison with a reference population. Eur J Cardiovasc Prev Rehabil. 2009; 16: 651-659. Ref.: https://goo.gl/ZjjoFp
  30. Larsson IM, Wallin E, Rubertsson S, Kristofferzon ML. Health-related quality of life improves during the first six months after cardiac arrest and hypothermia treatment. Resuscitation. 2014; 85: 215-220. Ref.: https://goo.gl/7FiF6e
  31. SWEDEHEART Annual report. 2015. 2015; Ref.: https://goo.gl/vQVrdG
  32. Frasure-Smith N, Lespérance F, Talajic M. The impact of negative emotions on prognosis following myocardial infarction: is it more than depression? Health Psychol. 1995; 14: 388-398. Ref.: https://goo.gl/MiognK
  33. Myers V, Gerber Y, Benyamini Y, Goldbourt U, Drory Y. Post-myocardial infarction depression: increased hospital admissions and reduced adoption of secondary prevention measures--a longitudinal study. J Psychosom Res. 2012; 72: 5-10. Ref.: https://goo.gl/apxVqu
  34. Lampe FC, Whincup PH, Wannamethee SG, Ebrahim S, Walker M, et al. Chest pain on questionnaire and prediction of major ischaemic heart disease events in men. Eur Heart J. 1998; 19: 63-73. Ref.: https://goo.gl/ihKgk7
  35. Spertus JA, Jones P, McDonell M, Fan V, Fihn SD. Health status predicts long-term outcome in outpatients with coronary disease. Circulation, 106. 2002; 43-49. Ref.: https://goo.gl/8RVqG5
  36. Spertus JA, Winder JA, Dewhurst TA, Deyo RA, Prodzinski J, et al. Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease. J Am Coll Cardiol. 1995; 25: 333-341. Ref.: https://goo.gl/JxhnB1
  37. Lisspers J, Nygren A, Söderman E. Hospital Anxiety and Depression Scale (HAD): some psychometric data for a Swedish sample. Acta Psychiatr Scand. 1997; 96: 281-286. Ref.: https://goo.gl/to5wCG
  38. Schweikert B, Hahmann H, Leidl R. Validation of the EuroQol questionnaire in cardiac rehabilitation. Heart. 2006; 92: 62-67. Ref.: https://goo.gl/gg4tTv

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