While the incidence of depression after myocardial infarction has been studied, there is paucity of data on the prevalence of depression in patients presenting with angina like symptoms. We studied whether depressive symptoms are associated with presence & extent of coronary artery disease (CAD) or angina as graded by the Canadian Cardiovascular Society Classification System.
We prospectively enrolled patients who were referred for cardiac catheterization during a one month period. Patients with previously established CAD diagnosis (previous MI / CABG / previous cardiac catheterization / previous PCI etc.) were excluded. Patients were administered the Hamilton Rating Scale for Depression (HAM-D) questionnaire prior to undergoing cardiac catheterization. CAD was defined as an epicardial stenosis >50%.
33 of 45 patients completed the questionnaire and were included in the study, mean age 57 ± 8 years, 48%male. 58% of patients were found to have CAD. There was no significant difference between mean HAM D scores in patients with and without CAD (8.7+/−6.5 vs 8.4+/−7.4 in patients without CAD. There was no relationship between HAM D scores and the extent of CAD (r=-.09,p=.7). Depression scores were strongly correlated with anginal scores (r=.7,p=.01).
In a consecutive series of patients referred for cardiac catheterization, depressive symptoms were related to anginal symptoms but not to the presence or extent of angiographic coronary artery disease.
The strong relationship between depressive symptoms and anginal symptoms suggests that depression lowers the threshold for anginal chest pain or that anginal chest pain is another clinical manifestation of depression in a subset of patients.
S. Chhabra, None.