Süleyman AKKAYA, Cegerğun POLAT, Önder ÖZTÜRK, Hüseyin EDE

KORONER ANJİOGRAFİ LABORATUVARINA SEVKİ YAPILAN HASTALARDA; DEPRESYON, ANKSİYETE VE KORONER ARTER HASTALIĞI CİDDİYETİ İLİŞKİSİ

Amaç: Bu çalışmanın amacı, koroner anjiyografi (KAG) laboratuvarına sevk edilen hastalarda koroner arterhastalığı (KAH) varlığının anksiyete ve depresyon gibi psikolojik bozuklıuklar ile ilişkisini değerlendirmektir.Yöntem ve Gereç: Koroner anjiografi yapılan 163 hasta ardışık olarak çalışmaya dahil edildi. Tüm hastalarınsosyodemografik özellikleri, kardiyovasküler risk faktörleri, klinik özellikleri ve mevcut kullandığı ilaçları kaydedildi.Koroner anjiyografi sonrası anksiyete ve depresyon seviyeleri, Hastane Anksiyete ve Depresyon Ölçeğine(HADÖ) göre incelendi. KAH ciddiyetini sınıflamak için KAG sonuçlarına göre hastalar aşağıdaki gibi sınıflandırıldı:perkütan koroner girişim (PKG); koroner by-pass greftleme (CABG); non-kritik koroner lezyonlar; normalkoroner arterler. Sosyodemografik özellikler, klinik özellikler, koroner arter ciddiyeti HAD ölçümleriyle uygunbiçimde karşılaştırıldı.Bulgular: Çalışmaya 62 kadın hasta (%38) dahil edildi. 62 hastaya PKG uygulanıken 30 hasta CABG’ye gönderildi.55 hastad non-kritik KAH varken 12 hastada normal koroner arterler (yavaş akım dahil) mevcuttu. Sosyodemografikfaktörler arasında sadece kadın hastalar, düşük gelirli hastalar veya uyku sorunu olan hastalarsırasıyla erkek hastalara, yüksek geliri olan hastalara veya uyku sorunu olmayanlara kıyasla daha yüksek HADdeğerlerine sahipti. Sosyodemografik özellikler, kardiyovasküler risk faktörleri, klinik özellikler ve KAG sonuçlarınıiçeren çok değişkenli regresyon analizinde, anksiyete için sadece uykusuzluk varlığı (β=0,243; p

The Relation Between Anxiety, Depression and Severity of The Coronary Artery Disease Among The Patients Referred to Coronary Angiography Laboratory

Objective: The objective of this study was to evaluate the relationship of psychological disorders such as anxiety and depression with presence of coronary artery disease (CAD) among patients referred to coronary angiography (CAG) laboratory. Material and Methods: One hundred sixty three patients undergone CAG were consecutively included in the study. Sociodemographic features, cardiovascular risk factors, clinical features and current medications were recorded for all patients. The levels of anxiety and depression were examined according to Hospitalized Anxiety and Depression (HAD) measurements following coronary angiography (CAG). According to CAG results, the subjects were grouped to classify the severity of CAD as follows: percutaneous coronary intervention (PCI), coronary bypass grefting (CABG), non-critical coronary lesions, normal coronary arteries. Sociodemographic features, clinical features, severity of coronary artery disease were compared with HAD measurements accordingly. Results: The study included 62 female patients (38%). 62 patients were undergone for PCI, 30 patients were referred to CABG while 55 patients had non-significant CAD; 12 patients has normal coronary arteries (including slow flow). Among sociodemographic factors, only female patients, patient with low income or insomnia had significantly higher HAD values compared to male, high income or without insomnia respectively. In multivariate regression analysis including sociodemographic features, cardiovascular risk factors, clinical features and CAG results, only presence of insomnia (β=-0.243; p

PDF

___

1.Mora S, Manson JE. Aspirin for Primary Prevention of Atheroscleroticrotic Cardiovascular Disease: Advances in Diagnosis and Treatment. JAMA Intern Med. 2016;176:1195-204.
2. Lukkarinen H, Hentinen M. Assessment of quality of life with the Nottingham Health Profile among patients with coronary heart disease. J Adv Nurs. 1997;26:73-84.
3. Lukkarinen H, Hentinen M. Treatments of coronary artery disease improve quality of life in the long term. Nurs Res. 2006;55:26-33.
4. Pinheiro de Melo EM, Lopes Ferreira P. Quality of life 2 years after coronary revascularization. Enferm Clin. 2007;17:309-17
5. Karadede AA, Temamoğulları AV, Altındağ A, Ilgen S, İltımır K, Toprak N. The relation between hhe number and severıty of coronary artery stenosıs and tendency to depressıon and anxıety. T Klin Kardiyoloji 2001;14:98-103
6. Shapiro P. Kardiyovasküler Bozukluklar. In: Kaplan & Sadock’s Comprehensive Textbook of Psychiatry, 8. Baskı. Editörler: Benjamin J. Sadock, Virginia A. Sadock. Çeviri Editörleri: Hamdullah Aydın, Ali Bozkurt. Güneş Kitabevi, Ankara, 2007.
7. Carney R, Freedland K. Depression and Coronary Heart Disease: More Pieces of the Puzzle. Am J Psychiatry 2007;9:1307-9.
8. Musselman D, Evans D, Nemeroff C. The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Arch Gen Psychiatry 1998;55:580-92.
9. Akdemir A, Örsel S, Dağ İ Türkçapar MH, İşcan N, Özbay N. Hamilton Depresyon Derecelendirme Ölçeği (HDDÖ)’nin geçerliği, güvenirliği ve klinikte kullanımı Psikiyatri Psikoloji Psikofarmakoloji Dergisi. 1996;4:251–259
10. Özer ZC, Şenuzun F, Tokem Y. Miyokart enfarktüslü hastalarda anksiyete ve depresyonun incelenmesi. Arch Turk Soc Cardiol 2009;37:557-562
11. Ziegelstein RC, Fauerbach JA, Stevens SS, Romanelli J, Richter DP, Bush DE. Patients with depression are less likely to follow recommendations to reduce cardiac risk during recovery from a myocardial infarction. Arch Intern Med 2000;160:1818-23.
12. Carney RM, Blumenthal JA, Catellier D, Freedland KE, Berkman LF, Watkins LL, et al. Depression as a risk factor for mortality after acute myocardial infarction. Am J Cardiol 2003;92:1277-81.
13. AbuRuz ME, Alaloul F, Al-Dweik G. Depressive symptoms are associated with in-hospital complications following acute myocardial infarction. Appl Nurs Res. 2018;39:65-70.
14. van Harmelen AL, Gibson JL, St Clair MC, Owens M, Brodbeck J, Dunn V, et al. Friendships and Family Support Reduce Subsequent Depressive Symptoms in At-Risk Adolescents. PLoS One. 2016;11:e0153715.
15. de Jager TAJ, Dulfer K, Radhoe S, Bergmann MJ, Daemen J, van Domburg RT, et al. Predictive value of depression and anxiety for long-term mortality: differences in outcome between acute coronary syndrome and stable angina pectoris. Int J Cardiol. 2018;250:43-48.