Volume 8, Issue 3 (Summer 2020)                   Iran J Health Sci 2020, 8(3): 21-28 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Wan Adnan W N A, Ab Hamid S A, Sulong Z R, Hashairi Fauzi M. Depression in Acute Coronary Syndrome Patients: A Cross-sectional Study in Malaysia. Iran J Health Sci 2020; 8 (3) :21-28
URL: http://jhs.mazums.ac.ir/article-1-723-en.html
Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Abstract:   (1631 Views)
Background and purpose: Linked with high mortality rate, depression is common among acute coronary syndrome (ACS) patients. The current study sought to identify the factors associated with depression among ACS patients in Malaysia.
Materials and Methods: A cross-sectional study was conducted on 400 ACS patients in two Malaysian hospitals: Hospital Universiti Sains Malaysia (USM), Kelantan and Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. ACS patients were included if they were above 18 years of age, able to read and/or write in Bahasa Melayu language and had informed consent. Patients were excluded if they were intubated, had an altered mental status, mental retardation and had psychological problems prior to ACS. Depression in this study was defined as having dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest or involvement, anhedonia, and inertia among ACS patients. A questionnaire was distributed to all 400 ACS patients. Simple and multiple logistic regressions were used for data analysis.
Results: The mean (standard deviation) age of ACS patients was 60.4 (11.3) years at Hospital USM and 61.2 (10.4) years at HSNZ. Nearly all of the depressive-ACS patients were Malay (79.4%), 85.9% were male, and 79.7% were married. Approximately 87.7% of depressive-ACS patients had ischemic heart disease, 87.1% had stroke, 83.4% had hyperlipidaemia, 81.8% had diabetes mellitus, and 80.7% had hypertension. The factors associated with depression were female gender (adjusted odd ratio (OR): 2.48, 95% confidence interval (CI): 1.50, 4.10, p<0.001) and ischemic heart disease (adjusted OR: 2.44, 95% CI: 1.41, 4.25, p=0.002).
Conclusion: The results showed that female gender and ischemic heart disease were the most significant associated factors of depression among ACS patients.
Full-Text [PDF 411 kb]   (980 Downloads)    
Type of Study: Original Article | Subject: Health

1. World Health Organization. Cardiovascular diseases (CVDs). Available at:www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).Accessed August 4, 2020.
2. Ministry of Health Malaysia. Health Facts 2013. Health Informatics Centre. Planning Division, Ministry of Health Malaysia, 2013.
3. Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Executive summary: heart disease and stroke statistics-2010 update: a report from the American Heart Association. Circulation. 2010 Feb 23;121(7):948-54. [DOI:10.1161/CIRCULATIONAHA.109.192666] [PMID]
4. Carney RM, Freedland KE. Depression in patients with coronary heart disease. The American Journal of Medicine. 2008 Nov 1;121(11):S20-7. [DOI:10.1016/j.amjmed.2008.09.010] [PMID]
5. Bush DE, Ziegelstein RC, Patel UV, Thombs BD, Ford DE, Fauerbach JA, et al. Post‐Myocardial Infarction Depression: Summary. InAHRQ Evidence Report Summaries 2005 May. Agency for Healthcare Research and Quality (US).
6. Leong LK, ASM Zuhdi, MIA Hafidz, Clinical depression among patients with post-acute coronary syndrome: a prospective single-tertiary centre analysis. Singapore Medical Journal. 2020;1:17. [DOI:10.11622/smedj.2020079]
7. Vaccarino V, Badimon L, Bremner JD,et al; ESC Scientific Document Group Reviewers. Depression and coronary heart disease: 2018 ESC position paper of the working group of coronary pathophysiology and microcirculation developed under the auspices of the ESC Committee for Practice Guidelines. European Heart Journal. 2019.
8. Huffman JC, Celano CM, Beach SR,Motiwala SR, Januzzi JL. Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovascular Psychiatry Neurology. 2013;2013:695925 [DOI:10.1155/2013/695925] [PMID] [PMCID]
9. Davidson KW, Korin MR. Depression and cardiovascular disease: selected findings, controversies, and clinical implications from 2009. Cleveland Clinic Journal of Medicine. 2010 Jul;77(Suppl 3):S20. [DOI:10.3949/ccjm.77.s3.04] [PMID] [PMCID]
10. Kronish IM, Rieckmann N, Halm EA, Shimbo D, Vorchheimer D, Haas DC, et al. Persistent depression affects adherence to secondary prevention behaviors after acute coronary syndromes. Journal of General Internal Medicine. 2006 Nov;21(11):1178-83. [DOI:10.1111/j.1525-1497.2006.00586.x] [PMID] [PMCID]
11. Lauzon C, Beck CA, Huynh T, Dion D, Racine N, Carignan S, et al. Depression and prognosis following hospital admission because of acute myocardial infarction. Canadian Medical Association Journal. 2003 Mar 4; 168(5):547-52.
12. Whooley M, Unützer J. Interdisciplinary stepped care for depression after acute coronary syndrome. Archives of Internal Medicine. 2010 Apr 12; 170(7):585-6. [DOI:10.1001/archinternmed.2010.41] [PMID] [PMCID]
13. Amin AA, Jones AM, Nugent K, Rumsfeld JS, Spertus JA. The prevalence of unrecognized depression in patients with acute coronary syndrome. American Heart Journal. 2006 Nov 1; 152(5):928-34. [DOI:10.1016/j.ahj.2006.05.006] [PMID]
14. McGee HM, Doyle F, Conroy RM, De La Harpe D, Shelley E. Impact of briefly-assessed depression on secondary prevention outcomes after acute coronary syndrome: a one-year longitudinal survey. BMC Health Services Research. 2006 Dec; 6(1):9. [DOI:10.1186/1472-6963-6-9] [PMID] [PMCID]
15. Page KN, Davidson P, Edward KL, Allen J, Cummins RA, Thompson DR, et al. recovering from an acute cardiac event-the relationship between depression and life satisfaction. Journal of Clinical Nursing. 2010 Mar; 19(5‐6):736-43. [DOI:10.1111/j.1365-2702.2009.03106.x] [PMID]
16. Musa R, Fadzil MA, Zain ZA. Translation, validation and psychometric properties of Bahasa Malaysia version of the Depression Anxiety and Stress Scales (DASS). ASEAN Journal of Psychiatry. 2007 Jan 1;8(2):82-9.
17. IBM Corp Released 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk , NY: IBM Corp.
18. Furuya RK, Costa ED, Coelho M, Richter VC, Dessotte CA, Schmidt A, et al.. Anxiety and depression among men and women who underwent percutaneous coronary intervention. Revista da Escola de Enfermagem da USP. 2013 Dec 1; 47(6):1332-6. [DOI:10.1590/S0080-623420130000600012] [PMID]
19. Norris CM, Spertus JA, Jensen L, Johnson J, Hegadoren KM, Ghali WA. Sex and gender discrepancies in health-related quality of life outcomes among patients with established coronary artery disease. Circulation: Cardiovascular Quality and Outcomes. 2008 Nov;1(2):123-30. [DOI:10.1161/CIRCOUTCOMES.108.793448] [PMID]
20. Vural M, Acer M, Akbaš B. The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi. 2008 Feb 1;8(1).
21. Rosin LA. Relationship between Depression and Coronary Artery Disease in Postmenopausal Women. The University Of Arizona. 2005
22. Steptoe A, Molloy GJ, Messerli-Bürgy N, Wikman A, Randall G, Perkins-Porras L, et al. Fear of dying and inflammation following acute coronary syndrome. European Heart Journal. 2011 Jun 1; 32(19):2405-11. [DOI:10.1093/eurheartj/ehr132] [PMID]
23. Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosomatic Medicine. 2004 Nov 1; 66(6):802-13. [DOI:10.1097/01.psy.0000146332.53619.b2] [PMID]
24. Van Melle JP, De Jonge P, Spijkerman TA, Tijssen JG, Ormel J, Van Veldhuisen DJ, et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosomatic Medicine. 2004 Nov 1; 66(6):814-22. [DOI:10.1097/01.psy.0000146294.82810.9c] [PMID]

Add your comments about this article : Your username or Email:

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

© 2024 CC BY-NC 4.0 | Iranian Journal of Health Sciences

Designed & Developed by : Yektaweb