Depression in Acute Coronary Syndrome Patients: A Cross-sectional Study in Malaysia

Background and purpose: Linked with high mortality rate, depression is common among acute coronary syndrome (ACS) patients. The current study sought to identify the factors associated with depression among ACS patients in Malaysia. Materials and Methods: A cross-sectional study was conducted on ۴۰۰ ACS patients in two Malaysian hospitals: Hospital Universiti Sains Malaysia (USM), Kelantan and Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. ACS patients were included if they were above ۱۸ years of age, able to read and/or write in Bahasa Melayu language and had informed consent. Patients were excluded if they were intubated, had an altered mental status, mental retardation and had psychological problems prior to ACS. Depression in this study was defined as having dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest or involvement, anhedonia, and inertia among ACS patients. A questionnaire was distributed to all ۴۰۰ ACS patients. Simple and multiple logistic regressions were used for data analysis. Results: The mean (standard deviation) age of ACS patients was ۶۰.۴ (۱۱.۳) years at Hospital USM and ۶۱.۲ (۱۰.۴) years at HSNZ. Nearly all of the depressive-ACS patients were Malay (۷۹.۴%), ۸۵.۹% were male, and ۷۹.۷% were married. Approximately ۸۷.۷% of depressive-ACS patients had ischemic heart disease, ۸۷.۱% had stroke, ۸۳.۴% had hyperlipidaemia, ۸۱.۸% had diabetes mellitus, and ۸۰.۷% had hypertension. The factors associated with depression were female gender (adjusted odd ratio (OR): ۲.۴۸, ۹۵% confidence interval (CI): ۱.۵۰, ۴.۱۰, p<۰.۰۰۱) and ischemic heart disease (adjusted OR: ۲.۴۴, ۹۵% CI: ۱.۴۱, ۴.۲۵, p=۰.۰۰۲). Conclusion: The results showed that female gender and ischemic heart disease were the most significant associated factors of depression among ACS patients.

Keywords:

Acute Coronary Syndrome , Depression , Gender Identity