Associação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalar

Detalhes bibliográficos
Autor(a) principal: Oliveira, Norma Alves de
Data de Publicação: 2011
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UFS
Texto Completo: https://ri.ufs.br/handle/riufs/3802
Resumo: The association between depression and acute coronary syndrome (ACS) is common, but it remains underdiagnosed and undertreated, although there is evidence of influence in the poor outcome. The mechanisms defy scientific knowledge. This study investigated the presence of depression, psychosocial factors associated in ACS and the impact on in-hospital prognosis in patients admitted to the Chest Pain Unit of a referral center for cardiology. In a cohort study, 151 patients with ACS, responded to the Beck Depression Inventory and a clinical survey and were followed until hospital discharge. 51.7% (). The frequency of depression in ACS was 51.7% (95% CI: 57.0 to 72.2). Mild depression, moderate depression, dysthymia and atypical depression were statistically significant. In 13% of cases, depression was installed after the coronary event. Family history of ACS (p = 0.04), history of depression (p = 0.006), childhood trauma (p = 0.001), insomnia (p = 0.01), chronic pain (p = 0.004), irritability easy (p=0,005), trauma in adolescence (p=0,003), trauma in adulthood (p=0,0003), personality disorders with emotional instability (p=0,001) and recent trauma (p=0,004), were significantly higher in patients with depression. In multivariate analysis, independent variables associated with depression were trauma in adolescence (0.004), trauma in adulthood (p = 0.001), easy irritability (p = 0.04) and personality disorders with emotional instability (p = 0.03) and acute myocardial infarction (0.02). In-hospital outcomes, acute pulmonary edema (p = 0.01), reinfarction (p = 0.001), recurrent ischemic events (p = 0.0001) were more frequent in the group with depression. These also showed a longer duration of hospitalization (p = 0.001). Depression (oddis ratio (OR) = 5.93, p <0.0001), and ejection fraction, left ventricular (OR = 0.02; p= 0.01.) were predictive of cardiovascular complications. The results suggest an association between depression and ACS. Depression linked existed before the coronary event. Trauma in adolescents and adults, easy irritability, personality disorder, emotionally unstable were psychosocial variables predictive of depression in ACS. Patients with depression are more prone to cardiovascular events in hospital. Depression is a risk factor for ACS and a marker of poor prognosis and SCA can trigger symptoms of depression.
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spelling Oliveira, Norma Alves dehttp://lattes.cnpq.br/7754805423340718Sousa, Antônio Carlos Sobralhttp://lattes.cnpq.br/00425032288108272017-09-26T12:17:32Z2017-09-26T12:17:32Z2011-06-10https://ri.ufs.br/handle/riufs/3802The association between depression and acute coronary syndrome (ACS) is common, but it remains underdiagnosed and undertreated, although there is evidence of influence in the poor outcome. The mechanisms defy scientific knowledge. This study investigated the presence of depression, psychosocial factors associated in ACS and the impact on in-hospital prognosis in patients admitted to the Chest Pain Unit of a referral center for cardiology. In a cohort study, 151 patients with ACS, responded to the Beck Depression Inventory and a clinical survey and were followed until hospital discharge. 51.7% (). The frequency of depression in ACS was 51.7% (95% CI: 57.0 to 72.2). Mild depression, moderate depression, dysthymia and atypical depression were statistically significant. In 13% of cases, depression was installed after the coronary event. Family history of ACS (p = 0.04), history of depression (p = 0.006), childhood trauma (p = 0.001), insomnia (p = 0.01), chronic pain (p = 0.004), irritability easy (p=0,005), trauma in adolescence (p=0,003), trauma in adulthood (p=0,0003), personality disorders with emotional instability (p=0,001) and recent trauma (p=0,004), were significantly higher in patients with depression. In multivariate analysis, independent variables associated with depression were trauma in adolescence (0.004), trauma in adulthood (p = 0.001), easy irritability (p = 0.04) and personality disorders with emotional instability (p = 0.03) and acute myocardial infarction (0.02). In-hospital outcomes, acute pulmonary edema (p = 0.01), reinfarction (p = 0.001), recurrent ischemic events (p = 0.0001) were more frequent in the group with depression. These also showed a longer duration of hospitalization (p = 0.001). Depression (oddis ratio (OR) = 5.93, p <0.0001), and ejection fraction, left ventricular (OR = 0.02; p= 0.01.) were predictive of cardiovascular complications. The results suggest an association between depression and ACS. Depression linked existed before the coronary event. Trauma in adolescents and adults, easy irritability, personality disorder, emotionally unstable were psychosocial variables predictive of depression in ACS. Patients with depression are more prone to cardiovascular events in hospital. Depression is a risk factor for ACS and a marker of poor prognosis and SCA can trigger symptoms of depression.A associação entre depressão e síndrome coronariana aguda (SCA) é frequente, porém subdiagnosticada, embora haja evidências de influência na pior evolução. Os mecanismos relacionados desafiam o conhecimento científico. Esse trabalho investigou a presença da depressão, fatores psicossociais associados e prognóstico na SCA em pacientes admitidos em um centro de referência em cardiologia. Em uma coorte, 151 pacientes com SCA, responderam ao Inventário Beck de Depressão e a um inquérito clínico, sendo acompanhados até a alta hospitalar. Houve uma frequência de depressão prévia de 51,7% (IC95%: 57,0 - 72,2). Depressão leve, depressão moderada, distimia e depressão atípica tiveram significância estatística. Em 13% dos casos, sintomas de depressão se instalaram após o evento coronariano. Antecedentes familiares de SCA (p=0,04), história prévia de depressão (p=0,006), traumas na infância (p=0,001), insônia (p=0,01), dor crônica (p=0,004), irritabilidade fácil (p=0,005), personalidade com instabilidade emocional (p=0,001), traumas na adolescência (p=0,003), traumas na fase adulta p=(0,0003) e traumas recentes (p=0,004) foram significativamente maior no grupo com depressão (p=0,04). Na análise multivariada, as variáveis independentes associadas à depressão foram: dores crônicas (p=0,001), insônia (p=0,03), traumas na adolescência (0,004), traumas na fase adulta (p= 0,001), irritabilidade fácil (p=0,04), transtorno de personalidade com instabilidade emocional (p=0,03) e infarto agudo do miocárdio prévio (0,02). Na evolução intra-hospitalar, edema agudo de pulmão (p =0,01), reinfarto (p=0,001), eventos isquêmicos recorrentes (p= 0,0001) foram mais frequentes no grupo com depressão. Também estes apresentaram um maior tempo de internamento (p=0,001). Depressão (oddis ratio (OR)=5,93; p<0,0001), e fração de ejeção do ventrículo esquerdo (OR=0,02; .p=0,01.) foram preditoras de complicações cardiovasculares. Os resultados sugerem associação entre depressão e SCA. A depressão associada existia antes do evento coronariano. Traumas no adolescente e no adulto, irritabilidade fácil, transtornos de personalidade com instabilidade emocional foram variáveis psicossociais preditoras de depressão na SCA. Pacientes com SCA e depressão estão mais sujeitos a eventos cardiovasculares intra-hospitalares. A depressão, além de fator de risco para a SCA, é um marcador de pior prognóstico e a SCA pode desencadear sintomas de depressão.application/pdfporUniversidade Federal de SergipePós-Graduação em Ciências da SaúdeUFSBRDepressãoSíndrome coronariana agudaPrognósticoDepressionAcute coronary syndromePrognosisCNPQ::CIENCIAS DA SAUDEAssociação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalarinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSTEXTNORMA_ALVES_OLIVEIRA.pdf.txtNORMA_ALVES_OLIVEIRA.pdf.txtExtracted texttext/plain255484https://ri.ufs.br/jspui/bitstream/riufs/3802/2/NORMA_ALVES_OLIVEIRA.pdf.txt45d7162dce190e2e05568f9ac719d681MD52THUMBNAILNORMA_ALVES_OLIVEIRA.pdf.jpgNORMA_ALVES_OLIVEIRA.pdf.jpgGenerated Thumbnailimage/jpeg1345https://ri.ufs.br/jspui/bitstream/riufs/3802/3/NORMA_ALVES_OLIVEIRA.pdf.jpg48c508b118f6bfa7b4692c3b39417fd5MD53ORIGINALNORMA_ALVES_OLIVEIRA.pdfapplication/pdf1239525https://ri.ufs.br/jspui/bitstream/riufs/3802/1/NORMA_ALVES_OLIVEIRA.pdfafc0c1d8ae80cf01443018048f86d7faMD51riufs/38022017-11-28 16:06:51.853oai:ufs.br:riufs/3802Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2017-11-28T19:06:51Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false
dc.title.por.fl_str_mv Associação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalar
title Associação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalar
spellingShingle Associação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalar
Oliveira, Norma Alves de
Depressão
Síndrome coronariana aguda
Prognóstico
Depression
Acute coronary syndrome
Prognosis
CNPQ::CIENCIAS DA SAUDE
title_short Associação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalar
title_full Associação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalar
title_fullStr Associação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalar
title_full_unstemmed Associação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalar
title_sort Associação entre depressão, síndrome coronariana aguda e prognóstico intra-hospitalar
author Oliveira, Norma Alves de
author_facet Oliveira, Norma Alves de
author_role author
dc.contributor.author.fl_str_mv Oliveira, Norma Alves de
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/7754805423340718
dc.contributor.advisor1.fl_str_mv Sousa, Antônio Carlos Sobral
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/0042503228810827
contributor_str_mv Sousa, Antônio Carlos Sobral
dc.subject.por.fl_str_mv Depressão
Síndrome coronariana aguda
Prognóstico
topic Depressão
Síndrome coronariana aguda
Prognóstico
Depression
Acute coronary syndrome
Prognosis
CNPQ::CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv Depression
Acute coronary syndrome
Prognosis
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS DA SAUDE
description The association between depression and acute coronary syndrome (ACS) is common, but it remains underdiagnosed and undertreated, although there is evidence of influence in the poor outcome. The mechanisms defy scientific knowledge. This study investigated the presence of depression, psychosocial factors associated in ACS and the impact on in-hospital prognosis in patients admitted to the Chest Pain Unit of a referral center for cardiology. In a cohort study, 151 patients with ACS, responded to the Beck Depression Inventory and a clinical survey and were followed until hospital discharge. 51.7% (). The frequency of depression in ACS was 51.7% (95% CI: 57.0 to 72.2). Mild depression, moderate depression, dysthymia and atypical depression were statistically significant. In 13% of cases, depression was installed after the coronary event. Family history of ACS (p = 0.04), history of depression (p = 0.006), childhood trauma (p = 0.001), insomnia (p = 0.01), chronic pain (p = 0.004), irritability easy (p=0,005), trauma in adolescence (p=0,003), trauma in adulthood (p=0,0003), personality disorders with emotional instability (p=0,001) and recent trauma (p=0,004), were significantly higher in patients with depression. In multivariate analysis, independent variables associated with depression were trauma in adolescence (0.004), trauma in adulthood (p = 0.001), easy irritability (p = 0.04) and personality disorders with emotional instability (p = 0.03) and acute myocardial infarction (0.02). In-hospital outcomes, acute pulmonary edema (p = 0.01), reinfarction (p = 0.001), recurrent ischemic events (p = 0.0001) were more frequent in the group with depression. These also showed a longer duration of hospitalization (p = 0.001). Depression (oddis ratio (OR) = 5.93, p <0.0001), and ejection fraction, left ventricular (OR = 0.02; p= 0.01.) were predictive of cardiovascular complications. The results suggest an association between depression and ACS. Depression linked existed before the coronary event. Trauma in adolescents and adults, easy irritability, personality disorder, emotionally unstable were psychosocial variables predictive of depression in ACS. Patients with depression are more prone to cardiovascular events in hospital. Depression is a risk factor for ACS and a marker of poor prognosis and SCA can trigger symptoms of depression.
publishDate 2011
dc.date.issued.fl_str_mv 2011-06-10
dc.date.accessioned.fl_str_mv 2017-09-26T12:17:32Z
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dc.publisher.program.fl_str_mv Pós-Graduação em Ciências da Saúde
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dc.publisher.country.fl_str_mv BR
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