Abstract
Acute coronary syndrome (ACS) among Cardiovascular diseases (CVDs) is the major cause of mortality worldwide and are the leading cause of death in India also. ACS refers to any group of clinical symptoms compatible with acute myocardial ischemia and covers the spectrum of clinical conditions ranging from unstable angina to non-ST-segment elevation myocardial infarction (NSTEMI) to ST-segment elevation myocardial infarction (STEMI). Several surveys were conducted across the country over the past few years have shown a rising of major risk factors for CVD in all population. Depressive disorders are estimated as the second largest cause of loss in connection with social people and increased risk for death. Patients with post- ACS depression have significantly had more hospital visits and huge health care costs than similar patients without depression. The main aim of our study was to determine the clinical efficacy of antidepressants in post-acute coronary syndrome patients. A prospective observational study was done for about 6 months in general medicine and cardiology departments of Rajiv Gandhi Institute of medical sciences, a 750 bedded tertiary care teaching hospital. A total of 100 ACS patients were taken. Among 100 post ACS patients, 76 were found to have depressive episodes and were diagnosed with becks depression score by using 21 questionnaires and with DSV-V criteria. Most commonly used antidepressant was Sertraline. A Supportive measure such as preoperative counseling should be provided to prevent post-ACS depression was undertaken prior to therapy was significant to reduce the depressive condition.
Keywords: CVDs, ACS, STEMI, NSTEMI, Depression.
References
- Outpatient Medication Use and Health Outcomes in Post–Acute Coronary Syndrome Patients; Zhou Yang, Ade Olomu, et al.Am J Manag Care. 2006;12:581-587.
- Acute Coronary Syndromes: Diagnosis and Management, Amit Kumar, Christopher Cannon, et al.Mayo Clin Proc, October 2009;84(10):917-938
- Diagnostic Accuracy of Screening Tests and Treatment for Post–Acute Coronary Syndrome Depression, A Systematic Review of Jason A. Nieuwsma, D.; John W. Williams, Ann Intern Med. 2017;167:725-735.
- A study of drug utilization pattern in post-acute coronary syndrome (ACS) patients at tertiary care teaching hospital: a prosp-ective unicentric study, Vidhi Thaker, Kamlesh Patel, International Journal of Basic & Clinical Pharmacology | February 2017 | Vol 6 | Issue 2 Page 308-311.
- Drug utilization study in patients of the acute coronary syndrome on follow-up visits at a tertiary care center in Kolkata. Abhishek Ghosh, Asoke Kumar Das, et al.Asian Journal of pharmacy and life science ISSN 2231 – 4423, vol. 2 (2), April-June, 2012
- Centralized, Stepped, Patient Preference–Based Treatment for Patients With Post–Acute Coronary Syndrome Depression CODIACS Vanguard Randomized Controlled Trial, Karina Davidson, Ph.D.; J. Thomas Bigger, MD; JAMA Intern Med, March 7, 2013.
- Enhanced Depression Care for Patients with Acute Coronary Syndrome and Persistent Depressive Symptoms: Coronary Psychosocial Evaluation Studies Randomized Controlled Trial, Karina Davidson, Nina Rieckmann, et al.Arch Intern Med. 2010 April 12; 170(7): 600–608.
- Diagnostic Accuracy of Screening and Treatment of Post–Acute Coronary Syndrome Depression: A Systematic Review Evidence Summary AHRQ Pub. 18-EHC001-1-EF.November 2017.
- Depression in coronary artery disease: Novel pathophysiologic mechanisms and therapeutic implications, John Parissis, Katerina Fountoulaki, et al. International Journal of Cardiology 116 (2007) 153–160.
- The puzzle of depression and acute coronary syndrome: Reviewing the role of Acute inflammation, Lydia Poole, Chris Dickens; Journal of Psychosomatic Research 71 (2011) 61–68.
- Depressive symptoms and treatment after acute coronary syndrome, Jeffrey Ellis, Kim A. Eagle; International Journal of Cardiology 99 (2005) 443– 447.
Corresponding Author
K Leela Prasad Babu
Assistant Professor, Department of General Medicine, Rajiv Gandhi Institute of Medical Sciences, Kadapa