RESEARCH ARTICLE


Prevalence Estimates, Severity, and Risk Factors of Depressive Symptoms among Coronary Artery Disease Patients after Ten Days of Percutaneous Coronary Intervention



Sukaina I. Rawashdeh1, Rasheed Ibdah1, Khalid A. Kheirallah2, Abdullah Al-kasasbeh1, Liqaa A. Raffee3, Nasr Alrabadi4, Iyad S. Albustami5, Rabia Haddad6, Raed M. Ibdah7, Abdel-Hameed Al-Mistarehi2, *
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1 Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
2 Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
3 Department of Accident and Emergency Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
4 Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
5 Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
6 Department of Nursing, King Abdullah University Hospital, Irbid, Jordan
7 Division of Psychiatry, Department of Neuroscience, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan


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Creative Commons License
© 2021 Rawashdeh et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, PO Box: 3030, Irbid (22110), Jordan; Mobile: 00962 7 9828 4360; E-mail: awalmistarehi18@med.just.edu.jo


Abstract

Background:

Depression and cardiovascular disorders are significant determinants of health that affect the quality of life and life expectations. Despite the high importance of depression screening among Coronary Artery Disease (CAD) patients, the time being to assess and treat it remains controversial.

Objectives:

This study aims to assess the prevalence estimates and severity of depressive symptoms and determine the risk factors associated with developing such symptoms among CAD patients after ten days of Percutaneous Coronary Intervention (PCI).

Methods:

All patients who underwent elective PCI between October 5, 2019, and Mid-March 2020 and diagnosed with CAD were included in this cross-sectional study. CAD was defined as intra-luminal stenosis of ≥ 50% in one or more of the coronary arteries. Depressive symptoms were screened after ten days of the PCI utilizing the patient health questionnaire-9 (PHQ-9) tool. A linear regression model was used to assess the adjusted effects of independent variables on PHQ-9 scores. Electronic medical records, clinical charts, and PCI and echocardiogram reports were reviewed.

Results:

Out of 385 CAD patients, a total of 335 were included in this study, with a response rate of 87%. The participants' mean (±SD) age was 57.5±10.7 years, 75.2% were males, 43% were current smokers, and 73.7% had below bachelor's education. The prevalence estimates of patients with moderate to severe depressive symptoms (PHQ-9 ≥10) was 34%, mild depression 45.1%, and normal 20.9%. Female gender, low educational level and diabetes mellitus were found to be the significant independent predictors of depression among our cohort with (t(333) = 3.68, p<0.001); (t(333) = 5.13, p<0.001); and (t(333) = 2.79, p=0.042), respectively.

Conclusion:

This study suggests a high prevalence of depressive symptoms among CAD patients after ten days of PCI. Approximately one out of three patients with CAD have significant symptoms of depression, which is an alarming finding for clinicians. Moreover, this study demonstrates a lack of sufficient depression recognition and management in similar study settings. Integration of mental health assessment and treatment among patients with CAD as soon as after PCI is recommended for optimal and effective treatment and to obtain the best outcomes.

Keywords: Depression, Major depressive disorder, Coronary artery disease, Ischemic heart disease, Catheterization, Percutaneous coronary intervention, Jordan.