Correlational Research Between Depression And Characteristics Of Coronary Artery Lesions Of Elderly Patients

ObjectiveAnalysis of the correlation between depression in elderly patients with coronary heart disease and coronary artery lesion counts but also coronary artery stenosis degree, to discuss whether depression is a risk factor for coronary artery disease. Methods1.Collect the patients with age of 60 or more who have been preliminary diagnosed of coronary heart disease(CHD) from January 2014 to January 2015 in hospital. Then select 230 patients among them according to the inclusion criteria and exclusion criteria. In the case of informed consent all rows are proceed Hamilton depression rating scale measurement(non-depression group: 8 points; depression group:8 points or more(likely to be depressed: 8 ~ 20 points; certainly depression: 21 ~ 35 points; severe depression: > 35)).They all perform coronary angiography examination.According to the result of CAG,we exclude 30 peoples out of the crowd,then divide the remainder 200 patients into depression group(68) and the non-depression group(132) according to HAMD score.The coronary artery lesions feature is described as follows:(1) The coronary artery lesions vessel numbers is divided into 3 parts: single vessel lesion, double-vessel lesions and triple- vessel lesions;(2) To describe the degree of coronary artery stenosis with Gensini score.2.Use SPSS17.0 statistical software to analyze the differences of characteristics of coronary artery lesions between the depression group and non-depression group, and then analyze the correlation between depression and coronary artery lesion counts and coronary artery stenosis degree.To explore whether depression is a risk factor for coronary artery disease by making Multiariable Logistic regression model analysis at the same time. ResultsThe comparison of the number of coronary artery lesions between non-depression group and depression group: The triple-vessel lesions of elderly patients with CHD in the depression group have higher percentage, at 38.2%.But the triple vessel lesions of elderly patients with CHD in the non-depression group is only 9.8%. The number of coronary artery lesions in this two groups is significantly different(P=0.000). The percentage of patients with double-vessel lesions in the depression group is higher than that of non-depression group,up to 50.0%. But there was no statistically significant difference between the two groups(P=0.554).The percentage of patients with Single coronary artery lesions in the depression group is 44.7%,it has no statistical differences compared with that which is11.8% of non-depression group(P=0.000).The comparison of the degree of coronary artery stenosis between non-depression group and depression group: To make two samples non-parametric tests of the degree of coronary artery lesions(Gensini score) between depression group and non-depression group. According to the results between depression group and non-depression group of the degree of coronary artery stenosis in elderly patients with CHD,there is statistically significant difference(P=0.000,P<0.05). By comparing the median of the non-normal distribution data,and result is that the Gensini score of patients in depression group is higher than that of non-depression group.By making independent samples non-parametric tests between different subgroups:to compare possible depression group with certain depression group, we see that these two groups have no statistical significance in terms of Gensini score(P=0.212) and coronary artery lesion counts(P=0.563). By comparing possible depression group with severe depression group, we see that these two groups have statistically significant difference in terms of Gensini score(P=0.039),and the severe depression group is to be more serious(Gensini score high),and these two groups have no statistical significance in terms of coronary artery lesion counts(P=0.362).In addition,to compare certain depression group with severe depression group, we see that these two groups have no statistical significance in terms of Gensini score(P=0.296) and coronary artery lesion counts(P=0.521).The correlation between depression and characteristics of coronary artery lesions: The analysis of Spearman correlation shows that the depression scale(HAMD score) has Positive correlation with the number of coronary artery lesions,its coefficient of correlation is 0.422(P<0.01),In addition, the coefficient of correlation between depression scale(HAMD score) and the degree of coronary artery stenosis(Gensini score) is 0.258(P<0.01), the dyslipidemia has stronger correlation with the severity of coronary stenosis. the depression scale has stronger correlation with the degree of coronary artery stenosis.Multi-factor logistic regression analysis of coronary artery lesions counts: Take the coronary artery lesions counts as dependent variables, and put hypertension, diabetes, Hyperlipidemia, smoking, age, gender and depression as independent variables,and then making multiariable logistic regression model analysis. The results show that depression,hypertension, and age are the independent influence factors of coronary artery lesions counts(P<0.05), the risk of high coronary artery lesions counts in patients without hypertension and which age less than 60 years of age is lower.In addition, depression is a risk factor for coronary artery lesion counts,it seems that this crowd has a higher risk of coronary artery lesion counts much more.Multi-factor logistic regression analysis of the degree of coronary artery stenosis:Take the coronary artery lesions counts as dependent variables, and put hypertension, diabetes, Hyperlipidemia, smoking, age, gender and depression as independent variables,and then making multiariable logistic regression model analysis.The results show that Depression is a risk factor for the degree of coronary artery stenosis(Gensini score)(P< 0.05).The crowd in the degree of coronary artery stenosis are higher risk of more severity(Gensini score on the high side). Conclusion1.Coronary artery lesions counts for non-depressed elderly patients with CHD are more for single vessel lesions and double-vessel lesions.Coronary artery lesions for depressed elderly patients with CHD are more for double-vessel lesions and triple-vessel lesions.In addition,the degree of coronary artery stenosis(Gensini score) of depressed elderly patients with CHD are more serious than that of non-depressed elderly patients with CHD.2.There have no statistically significant difference between elderly patients with certain depression and the other patients who are in possible depression group or severe depression group.There have statistically significant difference in terms of Gensini score between the elderly patients with possible depression and other patients with severe depression,and the elderly patients with severe depression is to be more serious(Gensini score high),and these patients in different two groups have no statistical significance in terms of coronary artery lesion counts.3.As depressed elderly patients with CHD,the number of coronary artery lesions and the degree of coronary artery stenosis(Gensini score) are both have positive correlation with depression(HAMD score).4.depression,hypertension, and age are the independent influence factors of coronary artery lesions counts.Depression is a risk factor for the degree of coronary artery stenosis.As depressed elderly patients with CHD,the number of coronary artery lesions and the degree of coronary artery stenosis(Gensini score on the high side) are higher risk of more severity.