Relationship between psychosocial status, diabetes mellitus, and left ventricular systolic function in patients with stable multivessel coronary artery disease

Abstract

BACKGROUND: Negative emotional conditions contribute to the development of coronary artery
disease (CAD). Depression and anxiety are prognostic factors in patients with CAD. The aim
of our study was to investigate the association between emotional conditions and left ventricular
(LV) systolic functions in CAD.
METHODS: 168 patients (102 men, 66 women, mean age 66.3 ± 9.9 years) with stable angina
and multivessel disease (MVD) were included in the study. According to the LV ejection
fraction (LVEF) in echocardiography, patients were divided into two groups, the preserved group
(LVEF > 50%), and the impaired group (LVEF < 50%). The preserved group consisted of
94 patients and the impaired group consisted of 74 patients. Emotional status was evaluated
using the Hamilton Depression (HAM-D), Hamilton Anxiety (HAM-A), Beck Depression
Inventory (BDI), and Beck Anxiety Inventory (BAI) scores.
RESULTS: The prevalence of diabetes mellitus (DM) was significantly higher in the impaired
group than in the preserved group (29.8% vs 56.8%, p < 0.01). The HAM-D, HAM-A, BAI
and BDI scores were higher in the impaired group compared to the preserved group (HAM-D:
12.1 ± 3.3 vs 14.5 ± 2.3, p = 0.03; HAM-A: 12.7 ± 3.4 vs 14.3 ± 2.2, p = 0.01; BAI: 18.6 ±
± 6.4 vs 22.1 ± 6.6, p = 0.01 and BDI: 13.9 ± 2.5 vs 17.2 ± 2.0, p = 0.002, respectively). In
multivariate analysis, BDI scores (odds ratio [OR]: 2.197, < 95% confidence interval [CI]
1.101–4.387; p = 0.026), HAM-A scores (OR: 1.912, < 95% Cl 1.092–2.974; p = 0.041) and
DM (OR: 2.610, < 95% Cl 1.313–5.183; p = 0.006) were important risk factors for LV
dysfunction in stable patients with MVD.

CONCLUSIONS: This study demonstrated that emotional status and DM are factors associated
with impaired LV systolic function in patients with stable CAD.