“Study of Psychosocial Antecedents to Precipitation of Congestive Heart Failure in Cardiac Patients: A Prospective Observational Study”

Introduction: Psychosocial factors, such as stress, adversity, socioeconomic status, depression, and anxiety, are associated with overall health and with cardiovascular health in particular. Psychosocial risk factors have been frequently studied in relation to coronary heart disease. In observational studies, high levels of depression and anxiety have consistently been associated with incident coronary heart disease, whereas associations with hostility and social support have been mixed. However, psychosocial factors have been examined less often in HF. Among patients with HF, depression is the most commonly researched psychosocial risk factor. Aim of the study: The aim of this study was to determine the psychosocial antecedents to precipitation of congestive heart failure in cardiac patients. Methods: This was a prospective study and was conducted in the Department of Cardiology of Lugansk State Medical University (LSMU), Hospital No-01, Lugansk, Ukraine during the period from November, 2008 to September 2009. We included 120 patients with heart disease in our study. The patients were randomly divided into two groups – HF group (Patients who hadn’t any heart failure, n=60) and No-HF group (Patients who had heart failure, n=60) Result: In total 120 patients from both the groups completed the study. In our study we found majority (35.83%) of our patients were aged 61-70 years and most of our patients were female (62%) compared to male (38%). We found the mean age was 49.73 ± 8.9 years. Among all patients 76.67% were smoker, 70% had DM, 80% had history of hypertension, 31.67% had asthma, 59.17% had previous history of CVD and the mean duration of CVD was 3.29±2.41 years. The mean BMI was 27.67±4.24 kg/m2. TC, HDL & LDL was higher in no-HF group which indicates a lower risk of heart disease while Tg was higher in HF group indicating a great risk of heart disease. We also found CRP , albumin & fibrinogen was higher in HF group that indicates a greater risk of heart disease. Among all psychosocial factors, anger, anxiety, depressive symptoms, hostility and self-reported health were found higher in HF group compared to no-HF group. Conclusion: In our study, we found statistically significant relationships between psychosocial factors and incident HF. However, adverse levels of psychosocial factors played a role to be an indicator of HF development among cardiac patients. We found psychosocial risk factors such as anger, anxiety, depressive symptoms, hostility and self-reported health as an indicator of congestive heart failure among our cardiac patients.