Research Advance of Anxiety and Depression in Patient with Percutaneous Coronary Intervention

doi:10.12114/j.issn.1007-9572.2019.00.668

Abstract

Abstract: The psychological status of patients with coronary atherosclerotic heart disease（CAD） often changes greatly after percutaneous coronary intervention（PCI），but less attention has been paid to it by clinicians.This study summarized the research progress of anxiety and depression in patients with PCI.The epidemiology，risk factors，adverse effects and intervention measures were reviewed respectively.The incidence of anxiety and depression in patients with PCI was high and was highest in perioperative period，and the emotional symptoms of most patients were not relieved for a long time.Postoperative depression could even increase the long-term mortality，but postoperative anxiety may reduce the long-term mortality.Patients with anxiety and depression associated with PCI should choose appropriate intervention methods for the early intervention according to their actual situation.

Key words: Coronary atherosclerotic heart disease, Percutaneous coronary intervention, Anxiety, Depression

摘要： 　冠状动脉粥样硬化性心脏病（冠心病）患者行经皮冠状动脉介入治疗（PCI）前后心理状况常发生巨大变化，但较少受到临床医生的重视，本文总结了患者行PCI伴发焦虑、抑郁情绪的研究进展，分别从流行病学、危险因素、不良影响、干预措施角度进行综述。患者行PCI伴发焦虑、抑郁情绪发生率高，围术期最高，多数患者情绪症状长期存在不缓解。术后伴发抑郁甚至可以增加长期死亡率，但术后伴发焦虑却可能降低长期死亡率。冠心病行PCI伴发焦虑、抑郁患者应根据其实际情况选择适合的干预方式进行早期干预。

关键词: 冠心病, 经皮冠状动脉介入治疗, 焦虑, 抑郁

WANG Juan1,2,ZHANG Yulong 1, et al. Research Advance of Anxiety and Depression in Patient with Percutaneous Coronary Intervention[J]. Chinese General Practice, 2020, 23(23): 2938-2943. DOI: 10.12114/j.issn.1007-9572.2019.00.668.
王娟1,2,张雨龙1等. 经皮冠状动脉介入治疗伴发焦虑及抑郁情绪研究进展[J]. 中国全科医学, 2020, 23(23): 2938-2943. DOI: 10.12114/j.issn.1007-9572.2019.00.668.

References

［1］邱原刚，郑良荣，陈君柱，等．可疑冠心病患者行冠状动脉介入手术前后的心理状况调查［J］．中华流行病学杂志，2003，24（3）：224-228．DOI：10.3760/j.issn:0254-6450.2003.03.017.
QIU Y G，ZHENG L R，CHEN J Z，et al．Psychologic status and their influencing factors in patients suspected of coronary disease before and after coronary catheterization［J］．Chinese Journal of Epidemiology，2003，24（3）：224-228．DOI：10.3760/j.issn:0254-6450.2003.03.017.
［2］GU G Q，ZHOU Y Q，ZHANG Y，et al．Increased prevalence of anxiety and depression symptoms in patients with coronary artery disease before and after percutaneous coronary intervention treatment［J］．BMC Psychiatry，2016，16：259．DOI：10.1186/s12888-016-0972-9.
［3］KALA P，HUDAKOVA N，JURAJDA M，et al．Depression and anxiety after acute myocardial infarction treated by primary PCI［J］．PLoS One，2016，11（4）：e0152367．DOI：10.1371/journal.pone.0152367.
［4］李永斌，姚朱华，许振坤，等．冠心病患者介入术后焦虑抑郁情绪的变化及影响因素［J］．中华医学杂志，2012，92（21）：1498-1501．DOI：10.3760/cma.j.issn.0376-2491.2012.21.015.
［5］FURUYA R K，COSTA E D E C，COELHO M，et al．Anxiety and depression among men and women who underwent percutaneous coronary intervention［J］．Rev Esc Enferm USP，2013，47（6）：1333-1337．DOI：10.1590/S0080-623420130000600012.
［6］ZHANG P Y.Study of anxiety/depression in patients with coronary heart disease after percutaneous coronary intervention［J］．Cell Biochem Biophys，2015，72（2）：503-507．DOI：10.1007/s12013-014-0495-2.
［7］TROTTER R，GALLAGHER R，DONOGHUE J.Anxiety in patients undergoing percutaneous coronary interventions［J］．Heart Lung，2011，40（3）：185-192．DOI：10.1016/j.hrtlng.2010.05.054.
［8］SKAGGS B G，YATES B C.Functional status and search for meaning after percutaneous coronary intervention［J］．West J Nurs Res，2016，38（2）：248-261．DOI：10.1177/0193945914561129.
［9］PEDERSEN S S，SMITH O R，DE VRIES J，et al．Course of anxiety symptoms over an 18-month period in exhausted patients post percutaneous coronary intervention［J］．Psychosom Med，2008，70（3）：349-355．DOI：10.1097/PSY.0b013e3181656540.
［10］陈卓婷，管莉倩，叶树妹.心脏介入治疗血管迷走神经反射的护理［J］．广东医学院学报，2007，25（4）：512-513．DOI：10.3969/j.issn.1005-4057.2007.04.083.
CHEN Z T，GUAN L Q，YE S M.Nursing care of patients with vasovagal reflex treated by cardiac intervention［J］．Journal of Guangdong Medical College，2007，25（4）：512-513．DOI：10.3969/j.issn.1005-4057.2007.04.083.
［11］孙淑凤，殷少华，王晓宁.冠状动脉介入诊疗术患者焦虑与手术并发症的相关性分析［J］．国际护理学杂志，2015，34（7）：865-867．DOI：10.3760/cma.j.issn.1673-4351.2015.07.001.
［12］RICHTER V C，COELHO M，ARANTES E D E C，et al．Health status and mental health in patients after percutaneous coronary intervention［J］．Rev Bras Enferm，2015，68（4）：589-595，676-682．DOI：10.1590/0034-7167.2015680415i.
［13］VAN DEN BERGE J C，UTENS E M，DULFER K，et al．Can anxiety and depression，separately or in combination predict subjective health status 10 years post-PCI?［J］．Int J Cardiol，2015，186：57-59．DOI：10.1016/j.ijcard.2015.03.147.
［14］SIP?TZ J，FRIEDRICH O，H?FER S，et al．Health related quality of life and mental distress after PCI：restoring a state of equilibrium［J］．Health Qual Life Outcomes，2013，11：144．DOI：10.1186/1477-7525-11-144.
［15］FENG C，JI T，LIU Y，et al．Role of depression in secondary prevention of Chinese coronary heart disease patients receiving percutaneous coronary intervention［J］．PLoS One，2017，12（12）：e0187016．DOI：10.1371/journal.pone.0187016.
［16］SON Y J，KIM S H，PARK J H.Role of depressive symptoms and self-efficacy of medication adherence in Korean patients after successful percutaneous coronary intervention［J］．Int J Nurs Pract，2014，20（6）：564-572．DOI：10.1111/ijn.12203.
［17］ILES-SMITH H，MCGOWAN L，CAMPBELL M，et al．A prospective cohort study investigating readmission，symptom attribution and psychological health within six months of primary percutaneous coronary intervention［J］．Eur J Cardiovasc Nurs，2015，14（6）：506-515．DOI：10.1177/1474515114543227.
［18］李曦铭，李婷婷，丛洪良，等．抑郁对冠心病行再血管化治疗患者预后的影响［J］．中华心血管病杂志，2012，40（2）：99-103．DOI：10.3760/cma.j.issn.0253-3758.2012.02.005.
LI X M，LI T T，CONG H L，et al．Impact of depression on prognosis of patients with coronary heart disease undergoing revascularization［J］．Chinese Journal of Cardiology，2012，40（2）：99-103．DOI：10.3760/cma.j.issn.0253-3758.2012.02.005.
［19］PARK J H，TAHK S J，BAE S H.Depression and anxiety as predictors of recurrent cardiac events 12 months after percutaneous coronary interventions［J］．J Cardiovasc Nurs，2015，30（4）：351-359．DOI：10.1097/JCN.0000000000000143.
［20］WANG Z J，GUO M，SI T M，et al．Association of depression with adverse cardiovascular events after percutaneous coronary intervention［J］．Coron Artery Dis，2013，24（7）：589-595．DOI：10.1097/MCA.0b013e3283650234.
［21］MEYER T，HUSSEIN S，LANGE H W，et al．Anxiety is associated with a reduction in both mortality and major adverse cardiovascular events five years after coronary stenting［J］．Eur J Prev Cardiol，2015，22（1）：75-82．DOI：10.1177/2047487313505244.
［22］DAMEN N L，VERSTEEG H，BOERSMA E，et al．Depression is independently associated with 7-year mortality in patients treated with percutaneous coronary intervention：results from the RESEARCH registry［J］．Int J Cardiol，2013，167（6）：2496-2501．DOI：10.1016/j.ijcard.2012.04.028.
［23］VAN DIJK M R，UTENS E M，DULFER K，et al．Depression and anxiety symptoms as predictors of mortality in PCI patients at 10 years of follow-up［J］．Eur J Prev Cardiol，2016，23（5）：552-558．DOI：10.1177/2047487315571889.
［24］HADDAD N E，SALEH M N，ESHAH N F.Effectiveness of nurse-led video interventions on anxiety in patients having percutaneous coronary intervention［J］．Int J Nurs Pract，2018，24（4）：e12645．DOI：10.1111/ijn.12645.
［25］WEEKS B P，NILSSON U.Music interventions in patients during coronary angiographic procedures：a randomized controlled study of the effect on patients' anxiety and well-being［J］．Eur J Cardiovasc Nurs，2011，10（2）：88-93．DOI：10.1016/j.ejcnurse.2010.07.002.
［26］FOROOGHY M，MOTTAHEDIAN TABRIZI E，HAJIZADEH E，et al．Effect of music therapy on patients' anxiety and hemodynamic parameters during coronary angioplasty：A randomized controlled trial［J］．Nurs Midwifery Stud，2015，4（2）：e25800．DOI：10.17795/nmsjournal25800.
［27］KIM J M，STEWART R，LEE Y S，et al．Effect of escitalopram vs placebo treatment for depression on long-term cardiac outcomes in patients with acute coronary syndrome：a randomized clinical trial［J］．JAMA，2018，320（4）：350-358．DOI：10.1001/jama.2018.9422.
［28］SHAHMANSOURI N，FAROKHNIA M，ABBASI S H，et al．A randomized，double-blind，clinical trial comparing the efficacy and safety of Crocus sativus L.with fluoxetine for improving mild to moderate depression in post percutaneous coronary intervention patients［J］．J Affect Disord，2014，155：216-222．DOI：10.1016/j.jad.2013.11.003.
［29］HE S Y，QIAN Z Y，TANG F T，et al．Effect of crocin on experimental atherosclerosis in quails and its mechanisms［J］．Life Sci，2005，77（8）：907-921．DOI：10.1016/j.lfs.2005.02.006.
［30］SACHDEVA J，TANWAR V，GOLECHHA M，et al．Crocus sativus L.（saffron） attenuates isoproterenol-induced myocardial injury via preserving cardiac functions and strengthening antioxidant defense system［J］．Exp Toxicol Pathol，2012，64（6）：557-564．DOI：10.1016/j.etp.2010.11.013.
［31］GOYAL S N，ARORA S，SHARMA A K，et al．Preventive effect of crocin of Crocus sativus on hemodynamic，biochemical，histopathological and ultrastuctural alterations in isoproterenol-induced cardiotoxicity in rats［J］．Phytomedicine，2010，17（3/4）：227-232．DOI：10.1016/j.phymed.2009.08.009.
［32］SHIRALI S，ZAHRA BATHAIE S，NAKHJAVANI M.Effect of crocin on the insulin resistance and lipid profile of streptozotocin-induced diabetic rats［J］．Phytother Res，2013，27（7）：1042-1047．DOI：10.1002/ptr.4836.
［33］WANG Y，HAN T，ZHU Y，et al．Antidepressant properties of bioactive fractions from the extract of Crocus sativus L［J］．J Nat Med，2010，64（1）：24-30．DOI：10.1007/s11418-009-0360-6.
［34］BATTES L C，PEDERSEN S S，OEMRAWSINGH R M，et al．Beta blocker therapy is associated with reduced depressive symptoms 12 months post percutaneous coronary intervention［J］．J Affect Disord，2012，136（3）：751-757．DOI：10.1016/j.jad.2011.09.047.
［35］RONCELLA A，PRISTIPINO C，CIANFROCCA C，et al．One-year results of the randomized，controlled，short-term psychotherapy in acute myocardial infarction（STEP-IN-AMI） trial［J］．Int J Cardiol，2013，170（2）：132-139．DOI：10.1016/j.ijcard.2013.08.094.
［36］LOUCKS E B，BRITTON W B，HOWE C J，et al．Positive associations of dispositional mindfulness with cardiovascular health：the new England family study［J］．Int J Behav Med，2015，22（4）：540-550．DOI：10.1007/s12529-014-9448-9.
［37］LEE J，SONG Y，LINDQUIST R，et al．Nontraditional cardiac rehabilitation in Korean patients with coronary artery disease［J］．Rehabil Nurs，2017，42（4）：191-198．DOI：10.1002/rnj.268.
［38］周志明，许晓晗，梁静，等．冠心病患者戒烟对焦虑抑郁状态变化的影响［J］．中华内科杂志，2016，55（11）：854-858．DOI：10.3760/cma.j.issn.0578-1426.2016.11.008.
ZHOU Z M，XU X H，LIANG J，et al．The impact of cigarette cessation intervention on mental state of patients with coronary heart disease［J］．Chinese Journal of Internal Medicine，2016，55（11）：854-858．DOI：10.3760/cma.j.issn.0578-1426.2016.11.008.

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