Depressive disorders and quality of life in patients with acute coronary syndrome in real clinical practice
Authors: Koroleva E , Gilyarov M , Konstantinova E , Svet A , Popov E , Popova A 
Published: October 2021

Abstract

Background
The prevalence of depressive disorders has become more significant in recent years.

Objective
To study the prevalence of depressive disorders using Zung Anxiety Rating Scale (ZARS) in patients with acute coronary syndrome (ACS) in the daily work of the Regional Vascular Center (RVC) in various gender and social subgroups and to compare their severity with the life quality level.

Materials and methods
The survey included 116 (57 female and 59 male) patients, admitted to RVC with ACS from March to November 2020 (Group I), and 49 patients without ACS, comparable with demographic parameters (Group II). Patients were interviewed with the use of ZARS and the life quality assessment questionnaire (SF-36). Statistical data processing was carried out using Statistica v.13.3, Mann–Whitney U-test, Pearson's chi-squared test, Spearman's rank correlation coefficient. P values &lt;0.05 were considered statistically significant.

Results
In Group I the score on ZARS was higher or equal to 50 (depression) in 18% of cases: 15% female and 3% male patients (p&lt;0.05). The average score on ZARS was notably higher in women than in men (p&lt;0.05). In Group II depression was detected in 27% of cases, without gender differences. A negative correlation was established for the indicators of ZARS and SF-36: in Group I r=−0.62, p&lt;0.05, in Group II r=−0.76, p&lt;0.05. In Group I indicators of health physical component (SF-36) among women were: physical functioning 50, role functioning 34, general health 51, in men: 80, 58 and 63 respectively (p&lt;0.05). In Group II these indicators significantly differed only in physical functioning: 60 female and 72 male. In Group I depression was observed in 2% of working and in 30% of non-working patients (p&lt;0.05); in Group II: 0% and 34% respectively. In Groups I and II depression was found in 10% and 5% among married, in 31% and 43% among unmarried patients (p&lt;0.05). In Group I depression was detected in 31% among patients with diabetes, in 12% - without diabetes (p&lt;0.05). The other analyzed diseases did not have a significant effect on the depression score.

Conclusions
The presence of ACS did not effect on the severity of depressive disorders in comparison with patients with other cardiac pathology, but among women with ACS their severity and prevalence was significantly higher. The severity of depressive disorders was inversely associated with life quality. Among patients with ACS, the health physical component according to SF-36 was significantly lower in women than in men; without ACS - no gender differences. Lack of work and marriage negatively affected on the prevalence of depression among all examined patients. Patients with ACS and diabetes had more elevated level of depression; the presence of depressive disorders was in close relationship with the health physical component among women (according to SF-36). It is necessary to develop and implement specialized rehabilitation programs for this subgroup of patients.

Funding Acknowledgement
Type of funding sources: None.