ASSOCIATION BETWEEN THE WEIGHT LOSS AND ANXIETY, DEPRESSION AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY: A NEED FOR PRE-DISCHARGED COUNSELING
Objectives: To see the association between weight loss and anxiety, depression after percutaneous transluminal coronary angioplasty (PTCA) for coronary artery disease patients. (1) To see the severity of anxiety and depression 1 month after PTCA, (2) to evaluate the relationship between the weight changes and major adverse cardiac events (MACE) in 1 month follow-up.
Methods: A total 1001 patients who underwent PTCA for acute coronary syndrome and coronary heart disease were included. Data were collected at baseline and 1 month after PTCA. A validated Euro 5Q-5D-5L questionnaire was used to assess the level of anxiety and depression. Chi-square test was applied to find out the association between weight loss status and anxiety, depression.
Results: There was a significant decrease in mean weight 1 month after coronary angioplasty (64.18Â±11.022 vs. 61.96Â±11.17, p<0.001). No association was observed between weight loss status and anxiety, depression in PTCA patients (p=0.5) and there is no significant association between weight changes and MACE 1 month after PTCA (p=0.92).
Conclusion: Data show that anxiety and depression were observed in 64.9% of the study population after coronary angioplasty but anxiety and depression are not associated with weight loss after PTCA. Loss of weight may be due to the modified post angioplasty lifestyles such as adherent to Mediterranean diet, physical exercise, cessation of smoking, optimum control of blood pressure, blood sugar, and blood cholesterol along with prescribed medications. Anxiety and depression may turn into chronic stage if not treated wisely could lead to significant MACE. Proper pre-hospital discharge counseling is necessary for all post PTCA patients to sustain their quality of life.
2. Powell BD, Lennon RJ, Lerman A, Bell MR, Berger PB, Higano ST, et al. Association of body mass index with outcome after percutaneous coronary intervention. Am J Cardiol 2003;91(4):472-6.
3. Smith SC, Blair SN, Bonow RO. AHA/ACC guidelines for preventing heart attack and death in patients with atherosclerotic cardiovascular disease: 2001 update-a statement for healthcare professionals from the American heart association and the American college of cardiology. J Am Coll Cardiol 2001;38:1581-3.
4. Pi-Sunyer FX. The obesity epidemic: Pathophysiology and consequences of obesity. Obes Res 2002;10 Suppl 2:97S-104.
5. Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: Pathophysiology, evaluation, and effect of weight loss an update of the 1997 American Heart Association scientific statement on obesity and heart disease from the obesity committee of the council on nutrition, physical activity, and metabolism. Circulation 2006;113(6):898-918.
6. Pack QR, Rodriguez-Escudero JP, Thomas RJ, Ades PA, West CP, Somers VK, et al. The prognostic importance of weight loss in coronary artery disease: A systematic review and meta-analysis. Mayo Clin Proc 2014;89(10):1368-77.
7. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: Final report of the Lyon Diet Heart Study. Circulation 1999;99(6):779-85.
8. Kocz1 R, Hassan MA, Perala PR, Negargar S, Javadzadegan H, Nader ND. The effect of weight loss on the outcome after coronary artery bypass grafting in obese patients. Ann Card Anaesth 2012;15(3):190-8.
9. Lisspers J, Sundin O, Hofman-Bang C, Nordlander R, Nygren A, RydÃ©n L, et al. Behavioral effects of a comprehensive, multifactorial program for lifestyle change after percutaneous transluminal coronary angioplasty: A prospective, randomized, controlled study. J Psychosom Res 1999;46(2):143-54.
10. Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr 2005;82 1 Suppl:222S-5.
11. Yamada K, Ohki-Hamazaki H, Wada K. Differential effects of social isolation upon body weight, food consumption, and responsiveness to novel and social environment in bombesin receptor subtype-3 (BRS-3) deficient mice. Physiol Behav 2000;68(4):555-61.
12. van Leeuwen SD, Bonne OB, Avraham Y, Berry EM. Separation as a new animal model for self-induced weight loss. Physiol Behav 1997;62(1):77-81.
13. Hemingway H, Marmot M. Evidence based cardiology: Psychosocial factors disease: Systematic review of prospective cohort. BMJ 1999;318(7196):1460-7.
14. Booth JN 3rd, Levitan EB, Brown TM, Farkouh ME, Safford MM, Muntner P. Effect of sustaining lifestyle modifications (nonsmoking, weight reduction, physical activity, and mediterranean diet) after healing of myocardial infarction, percutaneous intervention, or coronary bypass (from the REasons for Geographic and Racial Differences in Stroke Study). Am J Cardiol 2014;113(12):1933-40.
15. Moattari M, Adib F, Kojuri J, Tabatabaee SH. Angina self-management plan and quality of life, anxiety and depression in post coronary angioplasty patients. Iran Red Crescent Med J 2014;16(11):e16981.
16. Rudisch B, Nemeroff CB. Epidemiology of comorbid coronary artery disease and depression. Biol Psychiatry 2003;54(3):227-40.
17. 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. Psychosom Med 2004;66(6):814-22.
18. Glassman AH, Bigger JT, Gaffney M, Shapiro PA, Swenson JR. Onset of major depression associated with acute coronary syndromes: Relationship of onset, major depressive disorder history, and episode severity to sertraline benefit. Arch Gen Psychiatry 2006;63(3):283-8.
19. Grace SL, Abbey SE, Irvine J, Shnek ZM, Stewart DE. Prospective examination of anxiety persistence and its relationship to cardiac symptoms and recurrent cardiac events. Psychother Psychosom 2004;73(6):344-52.
20. Huffman JC, Smith FA, Blais MA, Beiser ME, Januzzi JL, Fricchione GL. Recognition and treatment of depression and anxiety in patients with acute myocardial infarction. Am J Cardiol 2006;98(3):319-24.
21. Kaptein KI, de Jonge P, van den Brink RH, Korf J. Course of depressive symptoms after myocardial infarction and cardiac prognosis: A latent class analysis. Psychosom Med 2006;68(5):662-8.
22. Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: A meta-analysis. Psychosom Med 2004;66(6):802-13.
23. Frasure-Smith N, LespÃ©rance F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch Gen Psychiatry 2008;65(1):62-71.
24. Berkman LF, Blumenthal J, Burg M, Carney RM, Catellier D, Cowan MJ, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA 2003;289(23):3106-16.
25. Huffman JC, Celano CM, Januzzi JL. The relationship between depression, anxiety, and cardiovascular outcomes in patients with acute coronary syndromes. Neuropsychiatr Dis Treat 2010;6:123-36.
26. van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, et al. Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health 2012;15(5):708-15.
27. Lopez-Jimenez F, Wu CO, Tian X, Oâ€™Connor C, Rich MW, Burg MM, et al. Weight change after myocardial infarction - the Enhancing Recovery in Coronary Heart Disease patients (ENRICHD) experience. Am Heart J 2008;155(3):478-84.
28. Dagenais GR, Yi Q, Mann JF, Bosch J, Pogue J, Yusuf S. Prognostic impact of body weight and abdominal obesity in women and men with cardiovascular disease. Am Heart J 2005;149(1):54-60.
29. Elbur AI. Level of adherence to lifestyle changes and medications among male hypertensive patients in two hospitals in Taif; Kingdom of Saudi Arabia. Int J Pharm Pharm Sci 2015;7(4):168-72.
30. Bucholz EM. Excess weight and life expectancy after acute myocardial infarction: The obesity paradox reexamined. Am Heart J 2016;172:173-81.
31. Shen R, Dugay G, Rajaram K, Cabrera I, Siegel N, Ren CJ. Impact of patient follow-up on weight loss after bariatric surgery. Obes Surg 2004;14(4):514-9.
32. Damien HS. Are Depression, Anxiety, Body Mass Index, and Types of Surgery Predictive of Weight Loss and Psychological Outcomes After Bariatric Surgery, Columbia University Academic Commons; 2012. Available from: http://www.hdl.handle.net/10022/ac:p:13067.
33. Sadeghzadeh V. Effects of a lifestyle-change program on cardiac risk factors after angioplasty. Int Res J Appl Basic Sci 2013;4(1):234-8.
34. Natali A, Vichi S, Landi P, Severi S, Lâ€™Abbate A, Ferrannini E. Coronary atherosclerosis in Type II diabetes: Angiographic findings and clinical outcome. Diabetologia 2000;43(5):632-41.
35. Montgomery SA. Anxiety as part of depression. Acta Psychiatr Scand 1983;68:171-4.
36. Dola HS, Jadhava SS, Pisala MA, Shaikha SK, Shinde VR. Emerging trends in patient counselling: Current scenario. Int J Pharm Pharm Sci 2015;7(10):65-8.
37. Khairunnisa NA, Tanjung HR. Impacts of counseling on adherence to prescribed medications and blood pressure of hypertensive patients in four Indonesian primary health centers. Int J Pharm Pharm Sci 2015;7(3):114-7.
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