PREVALENCIA Y EVOLUCIÓN DE SINTOMAS DEPRESIVOS EN PACIENTES HOSPITALIZADOS POR INFARTO AGUDO AL MIOCARDIO Y SU RELACIÓN CON PROCEDIMIENTOS DE REVASCULARIZACIÓN

Resumen

BACKGROUND

Persistence of depressive symptoms after MI (myocardial infarction) is associated with adverse outcome. The relationship between depression and Invasive Revascularization Therapy (IRT) is not yet fully understood. The aim of the study was to evaluate the persistence of depressive symptoms after MI, and its relationship with social support, anxiety and IRT

Methods

45 patients were prospectively evaluated at admission to hospital with a diagnosis of MI (Killip I and II), and at follow up after 3 months post discharge. All patients completed the Beck Depression Inventory (BDI), The Zung Anxiety Inventory (ASI), and the MOS social support survey. Depressive symptoms were considered to be present if the BDI score was >10. IRT were registered: 64.4% underwent IRT, 11.1% revascularization surgery, 53.3% coronary angioplasty.

Results

87% were men, age 58 ± 11, 37% hypertensive, 15% diabetic, and 44% smokers. 44.4% scored>10 in the BDI at baseline assessment and 26.5% at 3 months follow-up (p<0.01). At baseline BDI score for IRT patients was 10,2 ± 5,1 and for no IRT patients 9,1 ± 4,4 (p=0.2). BDI score at 3 months follow up was 9,9 ± 5,6 for IRT patients and 4,1 ± 2,5 for no IRT patients (p< 0,001).

Scores in the BDI were significantly correlated to anxiety (r=0.531, p<0.001), and to perceived social support (r=-0.365, p=0.018), at baseline and remained significant at 3 months.

DISCUSSION

Depressive symptoms were frequent after MI, and decreased at follow up. However, patients who received IRT remained depressed at 3 months. The IRT group might represent a more vulnerable group with regards to the interaction between depression and cardiovascular outcomes.