Assessment of the Validity of the Psycho-Cardiological Comorbidity Index in the Practice of a Cardiologist

Abstract

Background. The feasibility of creating a screening Index for the comorbidity of mental disorders and cardiovascular diseases in the practice of the cardiologist dictates the need to validate existing algorithms.Aim. To validate the previously proposed Index of psychocardiac comorbidity in prediction of outpatient recommendation of psycho-pharmacotherapy for cardiology patients.Materials and methods. Medical records of 302 consecutive patients of cardiac in-patient department were retrospectively analyzed with ROC-curve to estimate the predictive value of previously proposed Index of psychocardiac comorbidity for out-patient recommendation of psycho-pharmacotherapy.Results. The prevalence of outpatient psycho-pharmacotherapy in the examined patients was 15.2 %; this group of patients was more polymorbid and was characterized by a higher proportion of women and a higher prevalence of a labile course of arterial hypertension. The sedative antipsychotics, non-benzodiazepine tranquilizers and mood stabilizers were predominant pharmacological groups. An analysis of reproducibility of Index of psychocardiac comorbidity was provided on a cohort of cardiology in-patient department (n = 302). Index calculated by using the formula I = C + 3(6)×Q + 3×W + 8×A (C – number of Comorbid diagnoses, Q – Quake in the chest, palpitations or arrhythmia, onset before 55 (3 points) or 50 (6 points) years; W – Women; A – labile Arterial hypertension). Area under ROC-curve in validation cohort was 0.828 ± 0.035 (p < 0.001). Positive predictive value of Index was maximal for the score of ≥ 13.Conclusion. The proposed Index of psychocardiac comorbidity is a valid tool to predict the prescription of psychopharmacotherapy in cardiology patients.

Keywords

• psychosomatic cardiology
• screening
• prognostic index
• validation