| Background: According to statistics, most inpatients with coronaryheart disease have anxiety or depression. Mental diseases, such as anxiety anddepression, are independent risk factors for coronary heart disease, affectingits therapeutic efficacy. For this reason, scholars appeal for integration ofcardiology with mental psychology, namely that patients are performed thepsycho-cardiology treatment model (PCTM) for comprehensive, scientificand standardized treatment.Objective:To discuss impacts of the psycho-cardiology treatment modelon psychological states, the quality of life, the blood lipid control, the cardiacfunction, clinical arrhythmic and cardiovascular events of patients with acutecoronary syndrome (ACS).Methods:One hundred patients with ACS were selected to randomlydivide into the PCTM group (50patients) and the control group (50patients).Meanwhile, their general clinical data were compared, including age, gender,diabetes, hypertension, smoking history, medication compliance andpercutaneous coronary intervention. Both groups were performedconventional treatments, including anticoagulation, thrombolysis/intervention,coronary artery dilatation, lipid regulation and anti-arrhythmia. The PCTMgroup used psycho-cardiology for psychological intervention at the same time.Patients’ psychological states were assessed by psychiatrists forcorresponding psychological interventions within one day after theiradmissions. Psychiatrists were responsible for the adjustment and the concreteimplementation of psychological intervention throughout the course, including cognitive therapy, behavioral therapy, mental support treatment andrelaxation therapy, and antianxietic and antidepressant medication if necessary.Both groups were tested with Hamilton anxiety scale (HAMA) and Hamiltondepression scale (HAMD) on admission, in one month and in three months,respectively; they were tested with Seattle angina questionnaire (SAQ) onadmission and in three months, respectively; they were recorded CHOL,HDL-C, LDL-C, NT-proBNP and LVEF on admission, in one month and inthree months, respectively. They were followed up and recorded their clinicalarrhythmic and cardiovascular events within6months.Results: Comparison of HAMD scores with HAMA scores:(1) HAMDscores of the control group and the PCTM group on admission were15.04±5.25and14.69±5.05, respectively, and there was no significantdifference between scores of both groups (P>0.05). In one month, HAMDscores of the control group and the PCTM group were19.17±5.21and11.96±5.12, respectively, which increased in the control group and decreasedin the PCTM group, with a statistical significance compared with those onadmission (P<0.05) and higher scores in the control group than in the PCTMgroup (P<0.05). In three months, HAMD scores of the control group and thePCTM group were22.56±4.99and11.60±4.95, respectively; and the scorescontinued to rise in the control group, with statistical significances comparedwith those on admission and in one month (P<0.05). The PCTM groupshowed lower scores than those on admission (P<0.05) and no significantdifference compared with those in one month (P>0.05), but scores were stillhigher in the control group than in the PCTM group (P<0.05).(2) HAMAscores in the control group and the PCTM group on admission were15.25±6.54and15.06±6.30, respectively, with no difference between both groups (P>0.05). Scores in both groups in one month were19.23±4.06and11.71±4.65, respectively; scores rose in the control group compared withthose on admission (P<0.05) while they decreased in the PCTM group(P<0.05); however, scores were higher in the control group than in the PCTMgroup (P<0.05). In three months, scores in both groups were22.81±3.93and12.44±4.13, respectively, with significant differences compared with those onadmission and in one month (P<0.05); the PCTM group showed lower scoresthan those on admission (P<0.05) and no significant difference comparedwith those in one month (P>0.05), but scores were still higher in the controlgroup than in the PCTM group (P<0.05).Comparison of SAQ scores: There was no difference between the controlgroup and the PCTM group on admission (P<0.05); in three months, alldimensions increased compared with those on admission (P<0.05); scores ofall dimensions were higher in the PCTM group than in the control group(P<0.05).Comparison of serum lipid parameters:(1) CHOL contents (mmol/l) ofthe control group and the PCTM group on admission were4.73±0.93and4.66±1.38, respectively, with no difference between both groups (P>0.05). Inone month, CHOL contents were4.43±0.83and4.03±0.92in both groups,respectively; those decreased in both groups compared with those onadmission (P<0.05) and the CHOL content was lower in the PCTM groupthan in the control group (P<0.05). In three months, CHOL contents were4.45±0.60and4.05±0.91, respectively; those decreased in both groupscompared with those on admission (P<0.05), with no significant changecompare with those in one month (P>0.05).(2) LDL-C contents (mmol/l) ofthe control group and the PCTM group on admission were3.12±0.42and 2.99±0.75, respectively, with no difference between both groups (P>0.05). Inone month, LDL-C contents were2.79±0.42and2.36±0.73in both groups,respectively; those decreased in the control group (P>0.05) and in the PCTMgroup (P<0.05) compared with those on admission, and those were higher inthe control group than in the PCTM group (P<0.05). In three months, LDL-Ccontents were2.72±0.43and2.33±0.55in both groups, respectively; thosedecreased in both groups compared with those on admission (P<0.05), withno difference compared with those in one month (P>0.05); the LDL-C contentwas higher in the control group than in the PCTM group (P<0.05). HDL-Ccontents of the control group and the PCTM group on admission were1.18±0.29and1.19±0.33, respectively, with no difference between bothgroups (P>0.05). In one month, HDL-C contents were1.18±0.28and1.16±0.33in both groups, respectively, with no significant change in bothgroups on admission (P>0.05); the comparison among groups still showed nodifference (P>0.05). In three months, HDL-C contents were1.18±0.30and1.18±0.34in both groups, respectively; those in both groups showed nochange on admission and in one month (P>0.05); there was no difference incomparison among groups (P>0.05).Comparison of cardiac function:(1) NT-proBNP contents (pg/ml) of thecontrol group and the PCTM group on admission were875.26±120.35and840.58±150.74, respectively, with no difference between both groups(P>0.05). In one month, NT-proBNP contents were430.78±132.15and370.67±198.11in both groups, respectively; those in both groups decreasedcompared with those on admission (P<0.05), but the NT-proBNP content washigher in the control group than in the PCTM group (P<0.05). In three months,NT-proBNP contents were450.38±159.12and375.34±110.16in both groups, respectively; those in both groups decreased compared with those onadmission (P<0.05), with no difference compared with those in one month(P>0.05); however, the NT-proBNP content was still higher in the controlgroup than in the PCTM group (P<0.05).(2) LVEFs (%) of the control groupand the PCTM group on admission were47.35±5.41and51.46±5.82,respectively, with no difference between both groups (P>0.05). In one month,LVEFs were55.33±6.35and62.77±6.13in both groups, respectively; LVEFsrose in both groups compared with those on admission (P<0.05), but that waslower in the control group than in the PCTM group (P<0.05). In three months,LVEFs were54.73±6.12and63.36±6.83in both groups, respectively; LVEFsrose in both groups compared with those on admission (P<0.05), with nodifference compared with those in one month (P>0.05); however, the LVEFwas still lower in the control group than in the PCTM group (P<0.05).Comparison of the arrhythmia and the reduction of HRV: Morearrhythmias and reductions of HRV occurred in both groups on admission,with no difference between both groups (P>0.05). In six months, in thecontrol group, except the onset of atrial fibrillation and the reduction of HRV,cases of arrhythmia reduced compared with that on admission (P<0.05); inthe PCTM group, except the atrial fibrillation, cases of arrhythmias andreductions of HRV reduced compared with that on admission (P<0.05); casesof ventricular premature beat, combination of both types of arrhythmias andreduction of HRV were lower in the PCTM group than in the control group(P<0.05).Comparison of clinical cardiovascular events：Comparison of clinicalarrhythmic and cardiovascular events in both groups after six months showedno difference in mortality (P>0.05); cases of recurrent angina pectoris and myocardial infarction and cases of readmission due to the heart failure werelower in the PCTM group than in the control group (P<0.05).Conclusion:The PCTM can improve psychological states and quality oflife of patients with ACS, help control the blood lipid, improve cardiacfunction, and reduce the incidence of arrhythmic and cardiovascular events. |
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