Prevalence and patterns of anxiety and depression in patients undergoing elective percutaneous transluminal coronary angioplasty

BACKGROUND: The use of elective percutaneous transluminalcoronary angioplasty (PTCA) as a treatment for coronary heartdisease is increasing. Despite this, little is known about the prevalence andpatterns of anxiety and depression experiencedby patients undergoing and recovering from this procedure. Anxiety and depression are factors knownto negatively influence recovery after a cardiac event. OBJECTIVE:The purpose of this study was to (1) describe the levels of anxiety anddepression reported by patientspre- and postelective PTCA, and (2) determine associations evident betweenanxiety and depression and thesociodemographic and clinical variables of gender, marital status, history ofacute myocardial infarction, andattendance at cardiac rehabilitation. METHODS: In this descriptive, repeated-measures investigation,patients (n  140) were requested tocomplete the Spielberger State Trait AnxietyInventory and Cardiac Depression Scale (CDS) at three time points: (1) before admission for elective PTCA (T1);(2) 6 to 8 weeks (T2) after PTCA; and (3) 6 to 8 months (T3) after PTCA. RESULTS: A typical participant was male (75%), ofEuropean ethnicity (90%), aged 62 years (standard deviation  10.7) with single or double vessel disease,and had attended cardiac rehabilitation in the past. At T1, 16% of men and 24% of women had stateanxiety scores comparable to those experienced by neuropsychiatric patients. Trait anxiety scoresremained relatively constant over time; higher scores at T1 were associated with past acute myocardialinfarction. CDS scores at T2 and T3 were significantly lower than those at T1. However, an unexpectedincrease in CDS scores occurred at T3, compared with T2. At T3, 14% of men and 10% of women weredepressed, relative to T1. CONCLUSION:The findings lend support for the closer surveillance of emotional status inthis population. Specialistnurses have the potential to play a greater role in identifying those at risk ofdeveloping anxiety and depression. However,this unmet need will remain unmet until specialist nurses who spend the most face-to-face time with patientsare equipped with the skills and resources to systematically identify those “at risk.” (HeartLung® 2005;34:393– 401.)