Effects Of PCI On Anxiety Or Depression Status Of The Aged Patients With NSTE-ACS

Objective: The aim of the trial was to evaluate the effects of PCI on anxiety or depression status of the aged patients with NSTE-ACS,which could guide the clinical practice.Methods: From March 2016 to October 2016,a total of 210 NSTE-ACS patients beyond 60 years old were enrolled in this trial.Eligible patients were randomly assigned to the PCI group or the non-PCI group.Inclusion criteria: 1)Patients fulfilled with the diagnostic criteria of 2012 NSTE-ACS guideline of CSC9(Chinese Society of Cardiology)and underwent coronary angiography(CAG);2)Beyond 60 years-old;3)Family relatives had signed operation informed consent;4)Willing to undertake mental measurement.Exclusion criteria: 1)Patients with acute myocardial infarction that needed emergency coronary angiography;2)Patients with previous history of PCI;3)Patients with serious organ failure that could not receive PCI treatment;4)Patients with cognitive dysfunction who were unable to cooperate;5)Patients receiving immunosuppressive agents;6)Patients beyond the age of 80.According to each patient’s conditions,all patients received suitable medications including anticoagulants,antiplatelet drugs,statins,βblockers,angiotensin converting enzyme inhibitor/angiotensin receptor blocker(ACEI/ ARB),Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were done 1 day before CAG,7 days and 1 month after CAG.All data were analyzed with SPSS 23.0.P<0.05(2-tailed)was considered statistically significant.Results: There were 210 eligible patients enrolled in this trial.Among them,100 were assigned to the PCI group(63 male,average age 66.8±4.3 years old)and 110 were assigned to the non-PCI group(73 male,average age 67.5±4.2 years old).All patients completed the trials according to the experimental design.1 Baseline characteristicsThere were no significant differences between the two groups in baseline characteristics,including gender distribution,age,weight,heart rate on admission,systolic pressure,random blood glucose,low-density lipoprotein(LDL),brain natriuretic peptide(BNP),hemoglobin and left ventricular ejection fraction(LVEF)(P>0.05).Besides,there were no significant differences between the two groups in patient distribution,with 8 non-ST segment elevation myocardial infarction(NSTEMI)patients in the PCI group,another 3 NSTEMI patients in the non-PCI group(P>0.05).Furthermore,there were no difference in medical treatment between the two groups(P>0.05).2 Comparison of anxiety state between the two groupsThere was no difference in anxiety distribution between the two groups before CAG,with 37 anxiety patients in the PCI group and 41 in the non-PCI group(P=0.976).Significant difference was observed between the two groups 7 days after CAG,with 42 anxiety patients in the PCI group and 32 in the non-PCI group(P=0.036).There was significant difference in anxiety distribution between the two groups 1 month after CAG,with 40 anxiety patients in the PCI group and 28 in the non-PCI group(P=0.024).There was no difference 7 days and 1 month between the two groups in anxiety state.3 Comparison of depressive state between the two groupsThere was no difference in depression distribution between the two groups before CAG,with 35 depressive patients in the PCI group and 38 in the non-PCI group(P=0.945).Significant difference was observed between the two groups 7 days after CAG,with 48 depressive patients in the PCI group and 35 in the non-PCI group(P=0.017).There was no difference in depression distribution between the two groups 1 month after CAG,with 44 depressive patients in the PCI group and 33 in the non-PCI group(P=0.035).There was no difference 7 days and 1 month in depressive state between the two groups.There were 22 patients with anxiety and depression in the PCI groups before CAG and 25 in the non-PCI group,which was not significantly different(P=0.900).The figure turned to 25 and 17 respectively 7 days after CAG,which was not significantly different either(P=0.084).There were 26 patients with anxiety and depression in the PCI groups 1 month after CAG and 15 in the non-PCI group,which was significantly different(P=0.024).There was no difference in anxiety and depressive state between the two groups5 Multivariate logistic regression analysis of the PCI groupMultivariate logistic regression analysis showed that solitude,illiteracy,low income,severe lesion,and stent number were risk factors of anxiety after PCI.Family history of early coronary heart disease,solitude,illiteracy,low income,severe lesion,and stent number were risk factors of depression after PCI.Conclusion: PCI treatment may contribute to the high incidence of anxiety and depression in aged patients.solitude,illiteracy,severe lesion,and stent number maybe the risk factors.4 Comparison of patients with anxiety and depression...