The Relationship between Depression Symptoms and Severity of Coronary Artery Disease in Patients Undergoing Angiography

Arsalan Salari; Asieh Ashouri; Arezoo Javadzadeh Moghtader; Zahra Ahmadnia; Iman Alizadeh

doi:10.18502/ijps.v15i4.4305

The Relationship between Depression Symptoms and Severity of Coronary Artery Disease in Patients Undergoing Angiography

Arsalan Salari

Asieh Ashouri

Arezoo Javadzadeh Moghtader

Zahra Ahmadnia

Iman Alizadeh

Abstract

Objective: Cardiovascular diseases are the main cause of mortality worldwide. Depression is one of the effective factors in the incidence of cardiovascular diseases like coronary artery stenosis. This study aimed to investigate the relationship between depression symptoms and severity of coronary artery disease (CAD) in patients scheduled for angiography.
Method: This prospective, cross sectional research was conducted on as many as 401 patients scheduled to undergo angiography at Dr. Heshmat heart hospital as the referral center in the north of Iran in 2016. Before cardiac catheterization, patients' demographic information (age, gender, level of education, and place of residence) and patients’ medical history (history of diabetes mellitus, hypertension, and family history of cardiac disease) were obtained. Also, Beck Depression Questionnaire 2 (BDI II) was completed by a psychologist before angiography. After collecting the data, SPSS v.21 and statistical tests such as Spearman correlation, and Mann-Whitney U regression were used to analyze the data.
Results: After controlling for age, sex, and having history of diabetes mellitus, no relation was found between having depression symptoms and more frequency of vessel involvement (OR = 1.35, 95% CI: 0.92 to 1.98, P =0.130) or higher severity of CAD (OR = 1.47, 95% CI: 0.95 to 2.28, P = 0.087). The results were similar for the relation between severity of depression symptoms and CAD extent or CAD severity.
Conclusion: The results of this study showed that in patients undergoing angiography, depression symptoms were not related to CAD severity and number of involved vessels. Depression was associated with angina, independently of CAD severity. Our study found no significant correlation between CAD severity and severity of depression. The reason may be that measuring depression at a single time point cannot accurately reveal the impact of this problem on the trend of atherosclerosis over time.

1. Mozafari A, Baharvand A, Mohebi, S.F H. Impact of Cardiac Rehabilitation on Depression after Percutaneous Coronary Intervention. Jour Health. 2016;7(9):356-64.
2. Soltani shal R, Aghamohammadian Sharbaf H, H K. The role of type D personality and emotional intelligence with mediating of perceived stress and coping styles in the quality of life of coronary heart disease patients. jour Kermansha Uni Med Sci. 2013;(8):449-59.
3. Mohseni Pouya H, Hajimiri K, Esmaeili Shahmirzadi S, et al. Relationship between Health Promoting Behaviors and Severity of Coronary Artery Stenosis in Angiography Departmalest in Mazandaran Heart Center. Jour Mazandaran Uni Med Sci. 2015;25(130):19-29.
4. Elderon L, Whooley MA. Depression and cardiovascular disease. Prog Cardiovasc Dis. 2013;55(6):511-23.
5. Mastrogiannis D, Giamouzis G, Dardiotis E, et al. Depression in patients with cardiovascular disease. Cardiol Res Pract. 2012.
6. Behrad B, Bahrami Ehsan H, Rostami Reza, et al. The Effect of Increasing HRV Resonance Frequency on Reduction of Depression in post-CABG patients. Applied Psycho Res Quarterly. 2015;1(6):61-88.
7. Hajebrahimi B, Kazemi Arababadi M. Inflammation and depression: Mechanisms and involved molecules Quarterly. Jour Sabzevar Uni Med Sci. 2013;20(3):380-88.
8. Nemeroff CB, Owens MJ. The role of serotonin in the pathophysiology of depression: as important as ever. Clin Chem. 2009;55(8):1578-9.
9. Bagherian R, Saneei H, Baghbanian A. Myocardial Infarction and Depression. Jour Isfahan Med Sch. 2011;29(127):102-14.
10. Tomfohr LM, Murphy ML, Miller GE, Puterman E. Multiwave associations between depressive symptoms and endothelial function in adolescent and young adult females. Psychosom Med. 2011;73(6):456-61.
11. Cooper DC, Milic MS, Tafur JR, Mills PJ, Bardwell WA, Ziegler MG, et al. Adverse impact of mood on flow-mediated dilation. Psychosom Med. 2010;72(2):122-7.
12. Frasure-Smith N, Lesperance F. Depression and Anxiety as Predictors of 2-Year Cardiac Events in Patients with Stable Coronary Artery Disease. JAMA psychiatry. 2015;72(8):1819-25.
13. Ford DE, Mead LA, Chang PP, et al. Depression is a risk factor for coronary artery disease in males: the precursors study. Arch Intern Med. 1998;158(13):1422-26.
14. Frasure-Smith N, Lespérance F, Talajic M. Depression following myocardial infarction. Impact on 6-month survival. Jama. 1993;270(15):1819-25.
15. Parakh K, Thombs BD, Fauerbach JA, Bush DE, Ziegelstein RC. Effect of depression on late (8 years) mortality after myocardial infarction. Am J Cardiol. 2008;101(5):602-6.
16. Carney RM, Rich MW, Freedland KE, Saini J, teVelde A, Simeone C, et al. Major depressive disorder predicts cardiac events in patients with coronary artery disease. Psychosom Med. 1988;50(6):627-33.
17. Hance M, Carney RM, Freedland KE, Skala J. Depression in patients with coronary heart disease. A 12-month follow-up. Gen Hosp Psychiatry. 1996;18(1):61-5.
18. Rugulies R. Depression as a predictor for coronary heart disease. a review and meta-analysis. Am J Prev Med. 2002;23(1):51-61.
19. Penninx BW, Beekman AT, Honig A, Deeg DJ, Schoevers RA, van Eijk JT, et al. Depression and cardiac mortality: results from a community-based longitudinal study. Arch Gen Psychiatry. 2001;58(3):221-7.
20. Sullivan MD, LaCroix AZ, Spertus JA, Hecht J. Five-year prospective study of the effects of anxiety and depression in patients with coronary artery disease. Am J Cardiol. 2000;86(10):1135-8, a6, a9.
21. Vaezzadeh N, Hosseini S.H. Depression after myocardial infarction. Jour Clin Excell. 2013;1(2):69-84.
22. Ekici B, Ercan EA, Cehreli S, Töre HF. The effect of emotional status and health-related quality of life on the severity of coronary artery disease. Kardiol Pol. 2014;72(7):617-23.
23. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.
24. Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. Braz J Psychiatry. 2013;35(4):416-31.
25. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN. Depress Anxiety. 2005;21(4):185-92.
26. Ahmadi SM, Masjedi Arani A, Bakhtiari M. Davazdah Emamy MH, Mohamadian R.Psychometric properties of Persian version of Beck depression inventory in coronary patients. universa medicina. 2019;
27. Salari A, Shakiba M, Mahdavi-Roshan M, Gholipour M, Naghshbandi M, Rajabi R. The association between various indices of obesity and severity of atherosclerosis in adults in the north of Iran. Medicine (Baltimore). 2016;95(50):e5670.
28. Janssen I, Powell LH, Matthews KA, et al. Relation of persistent depressive symptoms to coronary artery calcification in womales aged 46 to 59 years. Am J Cardiol. 2016;117(12):1884-89.
29. Kokkou E, Tousoulis D, Siasos G, et al. Association Between Symptoms of Anxiety and Depression and Severity of Coronary Artery Disease. Glob Heart. 2014;9(1): 222.
30. Carney RM, Freedland KE, Rich MW, et al. Ventricular tachycardia and psychiatric depression in patients with coronary artery disease. Am J Med. 1993;95(1):23-8.
31. Vural M, Satiroglu O, Akbas B, et al. Coronary Artery Diseasein Association withDepression or Anxiety among Patients Undergoing Angiography to Investigate Chest Pain. Tex Heart Inst J. 2009;36(1):17-35.
32. O'Malley PG, Jones DL, Feuerstein IM, Taylor AJ. Lack of correlation between psychological factors and subclinical coronary artery disease. N Engl J Med. 2000;343(18):1298-304.
33. Hayek SS, Ko YA, Awad M, Del Mar Soto A, Ahmed H, Patel K, et al. Depression and chest pain in patients with coronary artery disease. Int J Cardiol. 2017;230:420-6.
34. Vural M, Satiroğlu O, Akbaş B, Göksel I, Karabay O. Association between depression and anxiety symptoms and major atherosclerosis risk factors in patients with chest pain. Tohoku J Exp Med. 2007;212(2):169-75.
35. Abbasi SH, Kassaian SE, Sadeghian S, Karimi A, Saadat S, Peyvandi F, et al. Factors Associated with Depressive Symptoms in Young Adults with Coronary Artery Disease: Tehran Heart Center's Premature Coronary Atherosclerosis Cohort (THC-PAC) Study. Iran J Psychiatry. 2016;11(4):214-23.
36. Perez GH, Nicolau JC, Romano BW, Laranjeira R. [Depression and Acute Coronary Syndromes: gender-related differences]. Arq Bras Cardiol. 2005;85(5):319-26.
37. Naqvi TZ, Naqvi SS, Merz CN. Gender differences in the link between depression and cardiovascular disease. Psychosom Med. 2005;67 Suppl 1:S15-8.

Files	XML PDF (327KB)
Issue	Vol 15 No 4 (2020)
Section	Short Communication(s)
DOI	https://doi.org/10.18502/ijps.v15i4.4305
PMCID	PMC7610074
PMID	33240388
Keywords
Coronary Angiography Depression Symptom Severity of Coronary Artery Disease Stenosis

Rights and permissions
	This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

How to Cite

Salari A, Ashouri A, Javadzadeh Moghtader A, Ahmadnia Z, Alizadeh I. The Relationship between Depression Symptoms and Severity of Coronary Artery Disease in Patients Undergoing Angiography. Iran J Psychiatry. 2020;15(4):370-376.

Vancouver

Download Citation