Abstract
The incidence of depressive symptoms in patients with stable coronary artery disease (SCAD) has significantly increased. However, its pathogenesis and treatment mechanisms are still incompletely understood. In this study, 144 patients with SCAD were recruited. Depressive symptoms of patients with SCAD were evaluated using Zung Self-Rating Depression Scale during hospitalization, and the patients were categorized into two subgroups: the non-depressive and depressive groups (further divided into mild and moderate/severe depressive groups). The rate of moderate/severe depressive symptoms in patients with SCAD was 18.8%. The mean age of patients in the depressive and mild depressive groups was older than that of those in the non-depressive group, and patients in the moderate/severe depressive group had higher high-density lipoprotein (HDL) and lower creatinine (Cr) levels. Binary logistic regression analysis showed that lower low-density lipoprotein (LDL) levels were significantly associated with increased risks of mild depressive symptoms, whereas higher HDL and lower Cr levels were significantly associated with moderate/severe depressive symptoms, suggesting that patients with SCAD were prone to experience depressive symptoms, especially in the elderly. Abnormality in LDL, HDL, and Cr levels might contribute to the depressive symptoms.
Highlights
Depression, ranging widely from mild depressive symptoms to clinically diagnosed major depression, mainly characterized by depressed mood and loss of willpower, and accompanied by significant somatic or cognitive impairment, is an increasingly serious global problem [1, 2]
The study sample was composed of 144 patients with stable coronary artery disease (SCAD), and the rates of no depressive symptoms, mild depressive symptoms, and moderate/severe depressive symptoms were 23.6%, 57.6%, and 18.8%, respectively
The results of this study showed that the incidence of depressive symptoms in patients with SCAD were significantly higher than that in the local population, which was estimated by the WHO (2017), and the rate of moderate/severe depressive symptoms was 18.8%
Summary
Depression, ranging widely from mild depressive symptoms to clinically diagnosed major depression, mainly characterized by depressed mood and loss of willpower, and accompanied by significant somatic or cognitive impairment, is an increasingly serious global problem [1, 2]. 20%–51% of patients with coronary heart disease (CHD) have been afflicted by clinical depression or depressive symptoms, which are significantly higher than that of 4.3% of the local population estimated by the World Health Organization (WHO, 2017) [3, 4]. In patients with stable coronary artery disease (SCAD), the quality of life and health conditions decline sharply when complicated by depression, and depression is one of the independent risk factors for adverse cardiovascular events [5, 7, 8]. The 2012 American Heart Association Guidelines and 2013 European Society of Cardiology Guidelines on the management of SCAD ( known as stable ischemic heart disease) have already emphasized the need to screen depression in patients with SCAD and the necessity to provide appropriate interventions [9, 10]. Because of the lack of necessary and sufficient understanding, depressive symptoms are usually masked under physical illness or manifest as severe somatic symptoms inconsistent with disease severity, for which making a correct diagnosis and taking appropriate intervention are difficult for clinicians
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