Subdepression effect on the therapeutic and prophylactic activity of patients with existing coronary artery disease
Authors: Tsygankova O , Evdokimova N , Platonov D , Veretyuk V , Ragino Y 
Published: October 2021

Abstract

Purpose
The purpose of this research is to study the relations between subdepression and indicators of therapeutic and preventive activity in patients with a previous myocardial infarction.

Material and methods
245 outpatient patients of both sexes aged 35–65 years who had suffered a previous myocardial infarction was examined. Subdepression (50–59 points on the Zung scale) was detected in 24.0% of men and 41.2% of women (p=0.006). As for the age analysis, men and women were divided into two groups, taking into account the median distribution: from 35 to 55 years and over 55. The authors evaluated the smoking status and smoking cessation rate among previously smokers, healthy eating habits, the effectiveness of treatment of arterial hypertension (AH), patients' readiness to follow the doctor's therapeutic and preventive recommendations, and general awareness of the coronary artery disease (CAD) prevention and treatment (by means of the original comprehensive questionnaire). The level of statistical significance of all statistical tests was assumed to be 0.05. Odds ratios calculated from logistic regression coefficients were presented with 95% confidence intervals (CI).

Results
Among women, subdepression was particularly often associated with negative aspects of therapeutic and preventive behavior. Thus, if in men the presence of subdepression did not affect the smoking habit, in women it increased the chances of smoking 2.9 times at the time of the survey (95% CI 1.162–7.838) and 3.6 times reduced the chances of quitting smoking by this time among those who had previously smoked (95% CI 1.101–11.590) (Picture). The subdepression presence also reduced the chances of patients suffering from concomitant AH to reach the target blood pressure levels by the time of examination, especially in women aged 35–55 years – by 4.1 times (95% CI 0.932–17.803).
Women with signs of subdepression were less informed about the prevention and treatment of CAD compared to patients without this mood disorder, as well as men who did not demonstrate such sort of dependence. It was also detected that, regardless of age, women without subdepression were 11.1 times more likely to be more informed about the prevention and treatment of CAD (95% CI 1.654–74.728) than their peers with its presence. The readiness to perform therapeutic and preventive measures did not significantly change in the presence or absence of subclinical depression in both men and women within the studied age groups (p&gt;0.05). No similar patterns were found among men with CAD.

Conclusion
The detection of such a minimal mood disorder as subdepression and its timely correction contributes to an increase in therapeutic and preventive activity in the group of patients suffering from CAD (35–65 years old), which is most important for women.

Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The study was partially performed in the frame-work of the budget theme of the State assignment No. AAAA-A17-117112850280-2.