The Predictive Value of Depression and Anxiety on Protracted Cardiovascular Outcomes in Individuals with Acute Myocardial Infarction
The predictive value of depression and anxiety on protracted cardiovascular outcomes
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Background: Depression and anxiety are prevalent psychological comorbidities within the patient group with AMI (acute myocardial infarction) and correlate with harmful effects. This research aimed to examine the predictive value of anxiety and depression on HRQoL (health-related quality of life) and prolonged cardiovascular outcomes within individuals with AMI in Baghdad, Iraq.
Methods: This study, designed as a prospective cohort, enrolled 1,000 AMI patients from three tertiary care hospitals in Baghdad. Anxiety and depression were evaluated through the use of the PHQ-9 (Patient Health Questionnaire-9) and HADS (Hospital Anxiety and Depression Scale) at baseline. Over a 5-year follow-up period, the main endpoint was a composite of cardiovascular events, including recurrent AMI, cardiovascular mortality, and heart failure. Secondary outcomes included HRQoL, which was evaluated using the SF-36 (Short Form-36) questionnaire. Data analysis was performed employing linear mixed-effects models and Cox proportional hazards regression.
Results: At baseline, the prevalence of depression and anxiety was 42.6% (95% CI: 39.5-45.7) and 38.4% (95% CI: 35.4-41.4) (HADS) or 35.2% (95% CI: 32.2-38.2) (PHQ-9), respectively. After adjusting for confounders, baseline HADS-Anxiety (adjusted HR: 1.08, 95% CI: 1.04-1.12), HADS-Depression (adjusted HR: 1.06, 95% CI: 1.02-1.10), and PHQ-9 scores (adjusted HR: 1.05, 95% CI: 1.02-1.08) were significant predictors of cardiovascular events. Higher levels of depression and anxiety were additionally linked with lower SF-36 Mental and Physical Component Summary scores within the 5-year follow-up timeframe.
Conclusion: Anxiety and depression are highly prevalent among AMI patients in Baghdad and are significant predictors of reduced QoL and adverse cardiovascular events over five years. The results highlight the importance of comprehensive management and regular evaluation to identify depression and anxiety in individuals with AMI to improve outcomes and QoL.
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