Background: Negative psychological conditions are common in patients with cardiovascular diseases. Although depression has been scrutinized over the years in these patients, only recently has anxiety emerged as another important risk factor. The purpose of this study was to compare the parameters of psychological stress in a population of coronary patients with and without myocardial revascularization procedures and to analyze lifestyle and socio-economic contributors to the state of health of these patients before inclusion in a comprehensive individualized rehabilitation program. Methods: This study included 500 patients with coronary artery disease (CAD) in stable condition divided in 2 groups: 200 patients who underwent coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA) (Group 1) and 300 patients without myocardial revascularization (Group 2) with stable angina or thrombolyzed myocardial infarction. The protocol included screening for anxiety/depression after procedure using three different scales: Duke Anxiety-Depression Scale, Hospital Anxiety and Depression Scale (HADS) and the Type D Personality Scale (DS-14) scale that evaluates negative affectivity (NA) and social inhibition (SI). Results: Significant differences between groups were observed for HAD-A (9.1 ± 4.18 for Group 1 vs. 7.8 ± 4.03 for Group 2, p = 0.002) and DUKE scores (30.2 ± 12.25 for Group 1 vs. 22.7 ± 12.13 for Group 2, p < 0.001). HAD-A scores (p = 0.01) and DUKE scores (p = 0.04) were significantly higher in patients who underwent PTCA vs. CABG. CAD patients without myocardial revascularization (Group 2, n = 300) presented anxiety in proportion of 72.3% (n = 217) out of which 10.7% (n = 32) had severe anxiety, and 180 patients had depression (a proportion of 60%) out of which 1.3% (n = 4) presented severe depression. The correlation between the presence of type 2 diabetes mellitus (T2DM) and type D personality in revascularized patients (n = 200) was significant (Chi2 test, p = 0.010). By applying multinomial regression according to the Cox and Snell R-square model and multivariate linear regression by the Enter method, we demonstrated that male gender, age and marital status proved significant predictors for psychological stress in our study population. Conclusions: The results obtained in this study provide a framework for monitoring anxiety, depression and type D personality in coronary patients before inclusion in comprehensive rehabilitation programs. Behavioral and psychological stress responses in patients with CAD significantly correlate with risk factors, and could influence the evolution of the disease. Moreover, other factors like gender, income and marital status also seem to play a decisive role. Evaluation of psychological stress parameters contributes to a better individualization at the start of these programs, because it allows adjusting of all potential factors that may influence positive outcomes.

中文翻译：

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以三项不同的问卷作为综合康复的先决条件，评估冠状动脉患者的心理压力参数。

背景：负性心理疾病在心血管疾病患者中很常见。尽管多年来对这些患者的抑郁症进行了仔细检查，但直到最近焦虑才出现，这是另一个重要的危险因素。这项研究的目的是比较有或没有心肌血运重建程序的冠心病患者的心理压力参数，并在纳入全面的个性化康复计划之前分析这些患者的健康状况的生活方式和社会经济因素。方法：本研究包括500例病情稳定的冠心病（CAD）患者，分为两组：200例行冠状动脉搭桥术（CABG）或经皮腔内冠状动脉成形术（PTCA）（第1组）和300例无心肌血运重建的患者（第2组）伴有稳定型心绞痛或溶栓性心肌梗塞。该方案包括在手术后使用三种不同的量表进行焦虑/抑郁筛查：公爵焦虑-抑郁量表，医院焦虑和抑郁量表（HADS）和用于评估负面情感（NA）和社交的D型人格量表（DS-14）。抑制（SI）。结果：观察到HAD-A组之间存在显着差异（第1组为9.1±4.18，第2组为7.8±4.03）。该方案包括在手术后使用三种不同的量表进行焦虑/抑郁筛查：公爵焦虑-抑郁量表，医院焦虑和抑郁量表（HADS）和评估负面情感（NA）和社交的D型人格量表（DS-14）。抑制（SI）。结果：观察到HAD-A组之间存在显着差异（第1组为9.1±4.18，第2组为7.8±4.03）。该方案包括在手术后使用三种不同的量表进行焦虑/抑郁筛查：公爵焦虑-抑郁量表，医院焦虑和抑郁量表（HADS）和用于评估负面情感（NA）和社交的D型人格量表（DS-14）。抑制（SI）。结果：观察到HAD-A组之间存在显着差异（第1组为9.1±4.18，第2组为7.8±4.03）。p = 0.002）和DUKE得分（第1组为30.2±12.25，第2组为22.7±12.13，p <0.001）。接受PTCA的患者相对于CABG的患者的HAD-A评分（p = 0.01）和DUKE评分（p = 0.04）显着更高。没有心肌血运重建的CAD患者（第2组，n = 300）表现出焦虑的比例为72.3％（n = 217），其中10.7％（n = 32）患有严重的焦虑，180例患有抑郁症（比例为60％） ），其中1.3％（n = 4）表现为严重抑郁。血运重建患者中2型糖尿病（T2DM）的存在与D型人格之间的相关性（n= 200）显着（Chi2检验，p= 0.010）。通过根据Cox和Snell R平方模型应用多项式回归并通过Enter方法应用多元线性回归，我们证明了男性，年龄和婚姻状况证明了我们研究人群心理压力的重要预测因子。结论：本研究获得的结果为在纳入综合康复计划之前监测冠心病患者的焦虑，抑郁和D型人格提供了框架。CAD患者的行为和心理压力反应与危险因素显着相关，并可能影响疾病的发展。此外，性别，收入和婚姻状况等其他因素似乎也起着决定性作用。