Clinical study on risk factors and anxiety-depression state in postmenopausal women with coronary atherosclerotic heart disease

Abstract

Objective To investigate the risk factors and anxiety-depression state in postmenopausal women with coronary atherosclerotic heart disease (CHD). Methods A total of 228 postmenopausal women with CHD undergoing coronary angiography from January 2015 to June 2016 were enrolled in this study. All patients were divided into the stent group (Gensini scores ≥ 41, n=150) and angiography group (Gensini scores<41, n=78). The levels of estradiol, total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), follicle-stimulating hormone (FSH) and homocysteine (HCY) were detected and compared. Logistic regression models were used to assess the potential risk factors of postmenopausal women with CHD. The hospital anxiety and depression scale (HADS) was compared by Ridit analysis. The relationship between Gensini scores and HADS scores was analyzed by Spearson correlation analysis. Results Compared with the angiography group, the levels of estradiol [(14.9 ± 1.1) ng/L vs. (10.9 ± 0.4) ng/L, t=3.324, P=0.001] and HDL-C [(1.236 ± 0.043) mmol/L vs. (1.132 ± 0.023) mmol/L, t=2.343, P=0.020] were much lower; the levels of total cholesterol [(5.16 ± 0.04) mmol/L vs. (6.18 ± 0.08) mmol/L, t=11.845, P<0.001], LDL-C [(2.90 ± 0.06) mmol/L vs. (3.72 ± 0.06) mmol/L, t=8.713, P<0.001] and HCY [(10.64 ± 0.26) μmol/L vs. (17.81 ± 0.60) μmol/L, t=11.057, P<0.001] were much higher in the stent group. However, there were no significant differences in FSH levels between the two groups [(20.9 ± 1.3) IU/L vs. (20.8 ± 0.7) IU/L, t=0.055, P=0.082]. The Logistic regression analysis showed that estradiol, total cholesterol, HDL-C, LDL-C and HCY were independent risk factors for postmenopausal women with CHD (all P< 0.05). The HADS scores in the angiography group were much better than those in the stent group (u=1.110, P < 0.05). The Spearson correlation analysis showed a positive correlation between the Gensini score and HADS score in the stent group (r=0.604, P < 0.05). Conclusion The risk factors of postmenopausal women with CHD include estrogen, total cholesterol, HDL-C, LDL-C and HCY, and the severity of coronary artery disease is positively correlated to patient's anxiety-depresssion state. Key words: Postmenopause; Coronary artery disease; Anxiety; Depression; Risk factors