Study On The Correlation Between Anxiety And Depression State And Cardiovascular Events After Coronary Revascularization And The Characteristics Of Syndromes

Purpose:To investigate the related factors influencing the anxiety and depression of patients after successful transcoronary revascularization,analyze the relationship between the occurrence and severity of anxiety and depression and cardiovascular events in such patients,and explore the main clinical features of cardiovascular disease combined with mental disorder through sorting out the distribution of syndrome types and accompanied symptoms of the patients,so as to guide the methods of clinical practice.Method:From September 2018 to December 2019,500 patients with successful transcoronary revascularization were selected for a bidirectional cohort study from the No.1Department of Cardiology of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine and the Heart Center of Liaoning People’s Hospital.Relevant clinical data were collected,including general data,diagnosis and treatment of coronary artery disease,anxiety,depression,cardiovascular end-point events;TCM syndrome types and syndrome elements,etc.The reliability analysis,frequency analysis,cluster analysis and multi-factor regression analysis of the collected data were carried out using Microsoft Excel and SPSS23.0.The obtained results were compared and evaluated.Results:1.Multi-factor analysis found that the factors associated with the occurrence of anxiety were sex,age,education,smoking and self-management.Among them,sex,age(45-59 years old),smoking was a risk factor for the occurrence of anxiety(P<0.05);education(college degree or above)work and rest(regular)self-management(active)was a protective factor for anxiety(P<0.05)2.The multivariate analysis found that the factors associated with the occurrence of depression included the history of allergies and self-management of smoking and rest in gender,education,marriage,and gender(P<0.05);education(college degree or above),marriage(married),work and rest(regular)and self-management(active)were protective factors for anxiety(P<0.05).3.Compared with non-depressed people,the higher the degree of depression,the higher the risk of cardiovascular events.Compared with non-depressed people,the risk of cardiovascular events increased by 19.426(20.426-1)times in mildly depressed people.The odds ratio(95%ci)was 20.426(9.992-41.756).4.Compared with non-anxious people,the higher the degree of anxiety,the higher the risk of cardiovascular events.Compared with non-anxious people,people with severe anxiety had a21.519(22.519-1)fold increased risk of cardiovascular events.The odds ratio OR value(95%CI)was 22.519(6.366-69.652).5.In the patients after transcoronary revascularization,the accompanied symptoms were general symptoms(lassitude and asthenia,anxiety and irritability,shortness of breath,sweat more at ordinary times),chest and abdominal symptoms(chest tightness,shortness of breath,chest pain and palpitation),head and facial symptoms(dizziness,cough,tinnitus and thirst),dietary and sleeping symptoms(difficulty in falling asleep,festless sleep,insomnia,dreamy sleep,sleep late and wake up early),and limb,urination and defecation-related symptoms(limb numbness,cumbersome limbs,dry and hard stool and leg cramps)successively according to their frequency.Tongue coating was white,greasy,yellow and thin,tongue color was slightly dark,dark red,slight red and red,and pulse condition was thin,smooth,stringy and astringent,successively;ecchymosis occurred in 111 patients.6.Among the 450 patients,the syndrome elements of disease location were mainly in the heart(450,100.00%)and liver(196,43.56%);the excess syndrome elements were mainly blood stasis(401,89.11%),phlegm turbidity,43.11%(194)and qi stagnation(54,12.00%);the deficiency syndrome elements were mainly qi deficiency(267,59.33%)and yin deficiency(80,17.78%).Cluster analysis of the syndrome elements of 450 patients showed that the results could be divided into 6 categories: lung and liver;dampness of spleen and turbid phlegm;and qi stagnation;blood stasis and qi deficiency;heat accumulation,yin deficiency and kidney;heart.7.In this study,There were 148 cases of psycho-cardiological disease(32.89%),and the main TCM syndromes from high frequency to low frequency were: qi deficiency and blood stasis(41,27.70%),phlegm and blood stasis(39,26.40%),qi depression and phlegm stasis(27,18.20%),qi-yin deficiency and blood stasis(17,11.50%),qi stagnation and blood stasis(7,4.70%);there were 302 cases(67.11%)with with non-psychological heart disease,the main TCM syndromes from high frequency to low frequency were: phlegm and blood stasis(88,29.14%),qi deficiency and blood stasis(87,28.81%),qi-yin deficiency and blood stasis(38,12.58%),qi depression and phlegm stasis(29,9.60%),heart blood stasis(19,6.29%).Conclusion:1.In the patients after transcoronary revascularization,Factors associated with anxiety were sex,age,education,smoking and self-management;Factors associated with depression include gender,education,marriage,smoking history,allergies,and self-management.2.In this study,the main TCM syndromes of patients with psycho-cardiological disease were qi deficiency and blood stasis,phlegm and blood stasis,qi depression and phlegm stasis,qi-yin deficiency and blood stasis,and qi stagnation and blood stasis,successively from high to low in frequency;the main TCM syndromes of patients without psycho-cardiological disease were phlegm and blood stasis,qi deficiency and blood stasis,qi-yin deficiency and blood stasis,qi depression and phlegm stasis,heart blood stasis.3.In patients after coronary revascularization,anxiety and depression are risk factors for cardiovascular events,and the higher the degree of anxiety and depression,the greater the likelihood of cardiovascular events.