Correlation Between Anxiety And Depression With Clinical Indicators In Patients With AMI After Direct PCI

Objective:To investigate the status of anxiety and depression in patients with acute myocardial infarction(AMI)after direct percutaneous coronary intervention(PCI),and explore the effects of the severity of the disease on the anxiety and depression of AMI patients by clinical indicators,global registry of acute coronary events(GRACE)score,N-terminal pro-B-type natriuretic peptide(NT-proBNP),Creatine Kinase MB(CKMB)and left ventricular eject fraction(LVEF),as well as explore the impact of anxiety and depression on the length of hospitalization stay.It's aimed at seeking the influencing factors of AMI patients' early cardiac rehabilitation after direct PCI and providing theoretical basis for early cardiac rehabilitation.Methods:This study selected 200 AMI patients undergoing direct PCI who were hospitalized in a comprehensive third-grade class-A hospital in Nanchang from June 2019 to January 2020.The general information questionnaire and Hospital Anxiety Depression scale(HADS)were used to investigate patients' socio-demographic information,disease data(including GRACE score,NT-proBNP,CKMB,LVEF)and the status of anxiety and depression.The SPSS 25.0 software was used to analyze the data,and descriptive statistical methods were used to analyze the general data and anxiety and depression of AMI patients.Two independent samples t test and single factor ANOVA were chosen to analyze the differences of anxiety and depression in category variables.Pearson correlation coefficient was used to analyze the relationship between anxiety and depression and the continuous variables of normal distribution,and spearman correlation coefficient was used to analyze the relationship between anxiety and depression and the continuous variables of non-normal distribution.Multiple stepwise linear regression was applied to study the influencing causes of anxiety and depression.Spearman correlation coefficient was used to explore the relationship between the length of hospitalization stay and anxietyand depression.Results::1.The total score of anxiety and depression of AMI patients after direct PCI was15.95±4.629,the anxiety score was 9.55±2.490,and the depression score was6.40±2.593.There were 39 patients(19.5%)who had no symptoms of anxiety,94patients(47.0%)who had suspicious symptoms of anxiety and 67(33.5%)patients who had positive symptoms of anxiety;137 patients(68.5%)who had no symptoms of depression,53 patients(26.5%)who had suspicious symptoms of depression and10 patients(5.0%)who had positive symptoms of depression.The incidence of anxiety was 65%(130 cases),the incidence of depression was 22%(44 cases),and the incidence of anxiety and depression occurring simultaneously was 20%(40 cases).2.The score of anxiety and depression of 39 patients(19.5%)in GRACE low risk group was 13.90±4.633,the anxiety score was 8.69±2.408,and the depression score was 5.21±2.697.The score of anxiety and depression of 63 patients(31.5%)in GRACE middle risk group was 15.16±4.096,the anxiety score was 9.06±2.139,and the depression score was(6.10±2.545).The score of anxiety and depression of 98patients(49.0%)in GRACE high risk group was 17.28±4.576,the anxiety score was10.21±2.574,and the depression score was 7.06±2.393.3.Univariate analysis found that PCI path/puncture vessels had an effect on the anxiety of AMI patients after direct PCI(P<0.01),and monthly household income per capita had an effect on both anxiety and depression(P<0.01).4.Pearson /Spearman correlation coefficient analysis showed that the anxiety score of AMI patients after direct PCI was positively correlated with age,admission GRACE score,admission NT-proBNP,the second day CKMB,the third day CKMB and the fourth day CKMB,and the correlation coefficients were 0.144,0.334,0.204,0.208,0.181,0.286(P<0.05,P<0.01,P<0.01,P<0.01,P<0.05,P<0.01),respectively;the anxiety score was negatively correlated with LVEF for the next one to three days after direct PCI,and the correlation coefficient was-0.175(P<0.05).The depression score was positively correlated with age,admission GRACE score,admission NT-proBNP and the fourth day CKMB,and the correlation coefficients were 0.201,0.309,0.164,0.203(P<0.01,P<0.01,P<0.05,P<0.01),respectively;the depression score was negatively correlated with LVEF for the next one to three days after direct PCI,and the correlation coefficient was-0.164(P<0.05).5.Multiple stepwise linear regression showed that age,monthly household income per capita,admission GRACE score and the second day CKMB were the influencing factors of anxiety in patients with AMI after direct PCI;and monthly household income per capita,admission GRACE score and LVEF for the next one to three days after direct PCI were the influencing factors of depression.6.Spearman correlation analysis found that the length of hospitalization stay was positively correlated with anxiety and depression of patients with AMI after direct PCI,and the correlation coefficients were 0.581,0.429(P<0.01,P<0.01),respectively.Conclusion:1.In this study,the incidence of anxiety in AMI patients after direct PCI was relatively high,and the incidence of depression was lower than anxiety.2.The anxiety and depression of AMI patients after direct PCI was negatively correlated with monthly household income per capita,that is,the higher the income,the milder the anxiety and depression mood;it was positively correlated with admission GRACE score.3.The anxiety of AMI patients after direct PCI was positively correlated with age and the second day CKMB.The depression was negatively correlated with LVEF for the next one to three days after direct PCI.4.The length of hospitalization stay of AMI patients was positively correlated with both anxiety and depression emotion after direct PCI,that is,the more serious the anxiety and depression mood,the longer the hospitalization stay.The anxiety and depression mood could adversely affect the postoperative rehabilitation of patients with AMI after PCI.