Influence of psychological and coronary parameters on coronary patient rehospitalization

Abstract

Introduction. Psychological reactions are often comorbid with coronary risk factors and could be important for a six-month outcome. Objective. Determination of anxiety level, depression and aggression, persistence of risk health behaviour, stress life events, and coronary risk factors after coronary event and a predictive value of those parameters for six-month rehospitalization. Methods. In the group with Angina Pectoris (E1=30) and the group with Acute Myocardial Infarction (E2=33), there were applied, at baseline and after 6 months, the following: Semistructured Clinical Interview based on ICD-10, for depressive episode and anxiety disorder, Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), KON-6 sigma Scale for aggression, Holms-Rahe Scale (H-R) for stress events and Questionnaire for risk behaviour: alcohol consumption, smoking, lack of physical activity. Group differences were assessed by t-test and chi-square test, p<0.05, regression analysis for assessing initial variables, a predictive value for six month rehospitalization. Results. After acute coronary event, the anxiety and depression levels were mild and aggression was low in E1 and mild in E2. Stress event score was significantly higher in E2 (H-R=115.18) than in E1 (H-R=72.20), p<0.05. After 6 months, the results were the same except for a significantly lower stress event score in E1 (H-R=49.48), and in E2 (H-R=91.65), but still significantly higher than in E1. Coronary parameters were reduced, smokers' rate was increased in E1. Alcohol consumption, hypercholesterolaemia and hereditary tendency were predictive for six- month rehospitalization. Conclusion. After acute cardiac event, hospitalized coronary patients had a mild anxiety, depression and aggression level as well as after six months. The infarct patients had experienced more stress life events in the previous year than the angina patients. Risk health behaviour did not change in the following six months, with the increased smokers' rate in the angina group. Alcohol consumption, smoking and heredity were predictive for rehospitalization.

Keywords

• psychological parameters
• coronary parameters
• rehospitalization
• coronary patients