Relationships between anxiety–depression, perceived social support, and in-hospital outcomes among patients with acute myocardial infarction

Objective To examine associations between early anxiety–depression symptoms, perceived social support, and in-hospital outcomes in patients with acute myocardial infarction (AMI). Methods This observational cross-sectional study enrolled 150 consecutive AMI patients. Anxiety–depression symptoms and perceived social support were assessed within 24–72 hours of admission using the Hospital Anxiety and Depression Scale (HADS) and the Perceived Social Support Scale (PSSS). Primary outcome was in-hospital complications; secondary outcomes were length of stay and sleep quality. Multivariable regression models were applied with adjustment for age, cardiac function, emergency PCI, and major comorbidities. Results Clinically significant anxiety–depression symptoms (HADS ≥11) were present in 44.0% of patients; 27.3% developed at least one complication. Higher HADS scores were independently associated with increased complication risk, prolonged stay, and poorer sleep quality (all P < 0.05). Higher PSSS scores were associated with reduced complication risk, shorter stay, and better sleep quality (all P < 0.05). Psychosocial risk stratification demonstrated a significant gradient across all outcomes (trend P < 0.05), with results consistent across subgroup and sensitivity analyses. Conclusion Early anxiety–depression symptoms and perceived social support are independently associated with in-hospital outcomes in AMI patients. Routine psychosocial screening may help identify high-risk patients and guide individualized nursing care.