Table 3.
Summary of studies assessing anxiety after percutaneous coronary artery intervention
| Country Author | Patients and rating scale | Results | Conclusions |
|---|---|---|---|
| Netherland Pedersen et al. 2006[39] |
692 patients 6 and 12 months After PCI HADS |
471 (68.1%) had no symptoms of anxiety or depression, 62 (9.0%) had anxiety only, 59 (8.5%) had depressive symptoms only, and 100 (14.5%) had co-occurring symptoms | PCI patients with co-occurring anxiety and depression reported poorer health status compared with anxious/depressed only and no-symptom patients. Anxiety had incremental value to depressive symptoms in identifying those at risk for impaired health status |
| Iran Dehdari et al., 2008[40] |
75 PCI and 75 CABG patients STAI |
State anxiety 45.1±10.4 Trait anxiety 45.3±10.4 |
PCI patients had significantly higher anxiety as compared to CABG patients |
| India Chaudhury and Srivastava 2013[41] |
35 patients assessed before and 3 days after PCI HADS |
Anxiety at baseline 12.7±2.3 was significantly >3 days after PCI 6.1±1.5 | Successful PTCA resulted in significant reduction in anxiety |
| Brazil Furuya et al., 2013[42] |
59 patients assessed 2-7 months after PCI HADS |
Anxiety found in 66.7% men and 56.3% women | No significant difference in men and women regarding anxiety |
| Austria Sipötz et al., 2013[43] |
163 PCI patients HADS after intervention and at 1,6,12 and 24 months |
HADS - score decreased significantly from baseline to 1-month follow-up only | Mental distress declined in 1st month of follow-up. MHRQOL is negatively correlated to mental distress |
| Turkey Ekici et al., 2014 [44] |
225 PCI patients divided in to 3 groups: Normal coronary arteries (Gensini score 0, n=78, control group), minimal CAD (Gensini score 1-19, n=54), and significant CAD (Gensini score ≥20, n=93) HADS | Anxiety scores Control group=6.0 (3.5-9.0); Minimal CAD=7.0 (4.0-9.0); significant CAD=7.0 (4.0-11.0); P=0.459 (non significant) |
A significant positive correlation was found between HADS-anxiety and Gensini scores (r=0.139, P=0.038) |
| Iran Moattari et al., 2014[45] |
Experimental group (n=40) underwent a 12 weeks angina plan intervention consisting of 30 minutes counseling interview and telephone follow up. HADS at pretest and 3 months after PCI | Anxiety scores: Experimental group: Pretest 7.72±2.27; 3 months after PCI 6.57±1.72; Control group: Pretest 5.85±2.14; 3 months after PCI 5.92±2.30 | Mean changes between two groups was significant |
| Iran Sharif et al., 2014[46] |
Experimental group (n=40) participated in a 30-min training session before and after PTCA. The control group (n=40) received routine oral instructions before and after PCI. Both groups received an informative pamphlet at discharge. DASS on admission, at discharge, and 1 month after discharge | Anxiety scores Experimental group: T1=4.02±2.95; T2=3.40±2.83 T3=1.60±2.42 Control group: T1=4.12±3.09; T2=4.20±3.15; T3=4.82±3.51 Experimental group T1-T3 P<0.001 Experimental group T3-Control group T3 P<0.001 |
A planned discharge program in patients undergoing PTCA lowered their anxiety |
| Poland Uchmanowicz and Łoboz-Grudzień 2015[47] |
90 patients (55 men, 35 women) aged 39-84 undergoing coronary angioplasty. STAI in first week, after 6 months and 36 months | Changes in the levels of anxiety as a state and anxiety as a trait showed an unfavorable trend: STAI-state: 28.5 in the first week versus 34.3 in the 36th months (P<0.001); STAI-trait: 30.0 in the first week versus 33.9 in the 36th months (P<0.001) | More attention should be paid to anxiety accompanying CAD. There is a relationship between HRQOL and sex, age, anxiety and depression |
| China Lv et al., 2016[48] |
75 anxiety and depression patients after PCI randomly divided into CBT group (n=38) and control group (n=37) HAMD, HAMA, Chinese version, before, 3 days, and 8 weeks after PCI | HAM A scores in treatment and control group Before treatment was (23.3±7.9 and 24.2±8.1; P=0.62) which decreased to (10.6±3.4 and 16.5±4.6; P=0.003) respectively after 8 weeks |
HAM-A scores were decreased after treatment, but were more substantially reduced in patients that underwent CBT than those in the control group |
| Iran Pournaghash-Tehrani and Abdoli-Bidhendi 2016[49] |
90 patients undergoing PTCA. DASS 21 1 day before and 2 months after PTCA | There was a significant reduction of anxiety from pre PTCA to post PTCA in men (11.32±3.84-8.20±3.25) and women (11.06±3.62-7.19±3.20) respectively | PTCA was associated with improvement in anxiety of the patients |
| China Gu et al., 2016[50] |
170 randomly selected CHD patients undergoing PCI. HADS 1 day prior and after PCI, and at 1,3,6 and 12 months after PCI | PCI significantly associated with anxiety, and comorbid anxiety and depression (χ2=90.18, 64.83; P<0.01) at each follow-up | Anxiety, and comorbid anxiety and depression significantly increases 1 day before and after PCI; but significantly decreases with time following PCI |
| Netherland Delewi et al., 2107[51] |
2604 patients undergoing coronary angiography/PCI were included, with 70.4% male participants with a mean age of 65±12 years. VAS anxiety score at hospital intake, pre- and post-procedure, and at hospital discharge | At hospital intake the mean VAS anxiety score was 40.6±25.7. Mean preprocedural score was 43.9±26.8 and significantly declined postprocedure to 25.8±25.6 (P<0.001). The VAS anxiety score at hospital discharge was 19.5±21.7 | Female patients had significantly higher preprocedure VAS anxiety score (50.4±26.5) compared to males (41.5±26.8, P=0.02). Other factors associated with higher levels of anxiety were age <65 years, low level of education and an acute primary PCI |
| Colombia Della-Méa et al. 2018[52] |
266 patients who had undergone PCI; 68% men; average age 64.5 years (SD=8.9 years); beck anxiety inventory after PCI | 26.3% patients had minimal anxiety; 22.2% mild anxiety; 21.8% moderate anxiety; and 29.7% had severe anxiety | Assessing and treating psychological symptoms after PCI may improve patient’s adherence to treatment and their QOL |
| Norway Olsen et al., 2018[53] |
775 patients undergoing first time PCI at baseline and at 3 years follow up HADS | 27% of patients undergoing PCI reported symptoms of anxiety (score≥8 on HADS) | After 3 years, patients had higher level of anxiety than the reference population. Female gender and young age are associated with anxiety |
HADS – Hospital Anxiety and Depression Scale; STAI – Speilberger State trait anxiety inventory; DASS – Depression Anxiety Stress Scale; PCI – Percutaneous coronary artery intervention; CAD – Coronary artery disease; PTCA – Percutaneous transluminal coronary angioplasty; SD – Standard deviation; VAS – Visual Analogue Scales; CHD – Coronary heart disease; QOL – Quality of life; HRQOL – Health – related quality of life MHRQOL – MacNew HRQOL; CABG – Coronary Artery Bypass Graft; CBT – Cognitive behaviour therapy; HAMD – Hamilton depression rating scale; HAMA – Hamilton anxiety rating scale