Abstract
Psychiatric disorders (depression / anxiety) are linked to coronary artery disease (CAD). Coronary slow flow (CSF) is a relatively common form of CAD with the same underlying mechanisms that are attributed to many anatomic and pathophysiologic factors. However, the relationship between psychiatric disorders and CSF is less well-established; and this is the aim of this study. This cross-sectional observational study was conducted on the first 50 consecutive patients diagnosed with CSF by elective coronary angiography (CAG). They were compared with another 50 consecutive patients showing normal coronaries by CAG. Beck Anxiety Inventory and Beck Depression Inventory were used for assessment. CSF was diagnosed by coronary angiography "Thrombolysis In Myocardial Infarction" frame count. Lipid profile was obtained for all patients. Traditional risk factors (male gender, smoking, total cholesterol, low-density lipoproteins and triglycerides) were higher in the CSF group. Depression and anxiety scores were also higher in the CSF group. On multivariate analysis, male gender, depression and high triglycerides were the only significant independent predictors of CSF. A significant correlation existed between CSF and both anxiety and depression scores. Both scores were also significantly higher in multivessel vs single vessel affection. Psychiatric depression, male gender and high triglycerides are highly associated with CSF in patients undergoing elective CAG. There is a significant correlation between CSF severity and the severity of both anxiety and depression. Further studies are warranted to explore the impact of psychological intervention on CSF and its long-term outcome.
Highlights
The incidence of depression is 30%–40% of the general population [1] and 20%–40% of coronary artery disease (CAD) patients; and is associated with increased major adverse cardiovascular events (MACE).[2]
Psychiatric depression, male gender and high triglycerides are highly associated with Coronary slow flow (CSF) in patients undergoing elective coronary angiography (CAG)
There is a significant correlation between CSF severity and the severity of both anxiety and depression
Summary
The incidence of depression is 30%–40% of the general population [1] and 20%–40% of coronary artery disease (CAD) patients; and is associated with increased major adverse cardiovascular events (MACE).[2]. [7] It is seen in 1–7% of patients undergoing CAG[8] which is the only method for diagnosis.[9] It affects young male smokers most commonly[10] and is linked to both CAD (myocardial ischemia symptoms, life-threatening arrhythmias, recurrent acute coronary syndromes and sudden cardiac death) and psychological manifestations (anxiety, depression and psychological distress).[11,12,13] The pathogenesis of CSF involves mechanisms similar to those linked to anxiety/depression (inflammation, microvascular abnormalities, endothelial dysfunction and anatomical factors of epicardial arteries).[10] some studies indicate that patients with CSF have increased psychological distress compared with patients having coronary normal flow (CNF). The relationship between psychiatric disorders and CSF is less well-established; and this is the aim of this study
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