Depression and anxiety before and after percutaneous coronary intervention and their relationship to age

Background and Objective Percutaneous coronary intervention (PCI) is becoming a common practice in the treatment of patients with coronary heart disease (CHD) of all age. Depression is considered to be a risk factor for the development of CHD and deteriorates the outcome after cardiac rehabilitation efforts. The aim of our study was to evaluate the presence of clinically relevant anxiety and depression in patients before and after PCI. Additionally we evaluated their relationship to age because of the increasing number of elderly patients undergoing PCI. Methods One hundred and twelve consecutive patients in three Sanatoria for Retired Cadres in Beijing who underwent PCI were asked to fill in the Hospital Anxiety and Depression Scale (HADS) to measure depression and anxiety scores two days before and ten days after PCI. Differences between these pre- and post-surgical scores were then calculated as means for changes, and the amount of elevated scores was appraised. In order to investigate the relationship between age and anxiety and depression, respectively, Spearman correlations between age and the difference scores were calculated. In addition, ANOVA procedures with the factor “age group” and McNemar tests were calculated. Results 25.8% of the patients were clinically depressed before and 17.5% after PCI; 34.0% of the patients were clinically anxious before and 24.7% after PCI. This overall change is not significant. We found a significant negative correlation between age and the difference between the two time points for anxiety (Spearman rho = -.218, P = 0.03), but not for depression (Spearman rho = -.128, P = 0.21). ANOVA and McNemar tests revealed that anxiety scores and the number of patients high in anxiety declined statistically meaningful only in the youngest patient group. Such a relationship could not be found for depression. Conclusions Our data show a relationship between age and anxiety. Younger patients are more anxious before PCI than older ones and show a decline in symptoms while elderly patients show hardly any change.