The value of anxiety and depression in predicting physical function and major adverse cardiovascular events in patients with acute coronary syndrome

Background: Psychological distress, including anxiety and depression, is not only prevalent in patients with coronary heart disease (CHD) but can actually predict adverse clinical events. Therefore, the necessity of addressing psychological problems among patients with CHD to improve their treatment results is increasingly acknowledged. This study's objective was to examine the prognostic impact of anxiety and depression on major adverse cardiovascular events (MACEs) and physical function among patients with acute coronary syndrome (ACS). Methods: A total of 978 patients admitted to our hospital from September 2021 to September 2022 and diagnosed with severe vascular lesions using coronary angiography were enrolled. According to their scores on the Hospital Anxiety and Depression Scale (HADS) and the Center for Epidemiologic Studies Depression Scale at admission, they were divided into two groups and four subgroups: an anxiety group, a non-anxiety group, a depression group, and a non-depression group. The participants' baseline information, clinical characteristics, coronary angiography findings, MACEs, and changes in physical functionality were compared. Results: There were statistically significant differences between the anxiety and depression groups in marital status, education level, history of diabetes, clinical diagnosis, cardiac troponin T (cTnI), B-type natriuretic peptide (BNP), coronary angiography, and synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score. Logistic regression analysis showed that gender, education level, diabetes history, cTnI, and SYNTAX score were risk factors for anxiety, while education level, diabetes, and SYNTAX score were risk factors for depression. A Kaplan-Meier survival curve model was used to analyze survival rates in the anxiety and depression groups. Hierarchical regression analyses of anxiety and depression at baseline predicted significant declines in physical functionality. Conclusions: Social support improved physical functionality and reduced the impact of psychological distress. Psychological state had the greatest long-term prognostic value in patients with CHD.