Psychological Distress and Major Adverse Cardiovascular Events in Post-PCI Acute Myocardial Infarction: Risk Profiling and Management Implications

Abstract

Objective

This study examined the correlation between psychological status and major adverse cardiovascular events (MACE) in acute myocardial infarction (AMI) patients after percutaneous coronary intervention (PCI). Based on these results, health management strategies were discussed.

Methods

A retrospective analysis was conducted in 200 AMI patients who underwent PCI between January 2020 and December 2023 at a tertiary care hospital in China. The incidence of MACE was calculated, and the correlation between Hospital Anxiety and Depression Scale (HADS) scores and MACE was determined.

Results

Three-quarters (75.0%) of patients scored above the threshold on significant anxiety (HADS-A >9) and 61.0% did so for depressive symptoms (HADS-D >9) post-PCI. Multivariate analysis identified higher education (OR: 1.754, 95% CI: 1.080∼2.851), lower income (OR: 0.229, 95% CI: 0.089∼0.589), and smoking (OR: 0.384, 95% CI: 0.159∼0.931) as independent risk factors for anxiety, while low income (OR: 0.236, 95% CI: 0.105∼0.529), smoking (OR: 5.125, 95% CI: 2.213∼11.867), and female gender (OR: 3.042, 95% CI: 0.260∼7.348) were significantly associated with depression (P < 0.05). MACE occurred in 21.5% of patients. First-time PCI (OR: 0.03, 95% CI: 0.003∼0.296) and depression scores were significantly associated with increased MACE risk (r = 0.207, OR: 47.79, 95% CI: 8.38∼272.47, P < 0.05), whereas anxiety scores showed no significant association (P > 0.05).

Conclusion

Anxiety and depression are common post-PCI symptoms in AMI patients, and depressive symptoms are significantly correlated with disease progression (MACE scores). Greater focus on patients’ mental health, may help improve the prognosis of AMI patients after PCI.