LAUSR

Clinical depression is a known consequence of acute coronary syndrome (ACS). It is also known to carry an adverse outcome among these patients. Despite the availability of validated tools for screening of depression in acute coronary syndrome patients, depression is still significantly under-recognized and undertreated in patients with acute coronary syndrome. To investigate the prevalence of depression in post-ACS patients and the factors associated with it. Prospective cohort study conducted on 95 ACS patients (26 female, 69 male) admitted to our cardiology ward University. Data collected with consent from patients through electronic medical record and Patient Health Questionnaire (PHQ-9), Medical Adherence Questionnaire(MAQ). Depression outcome at 30-day was obtained from hospital records and via phone call to the patient. Data analyzed using SPSS 24.0. Chi-square test was used for comparison of categorical variables and independent t-test and Mann-Whitney U tests were used for comparison of continuous variables. Binary logistic regression was used to determine the independent associated factors for depression after adjusted with significant demographic variables and clinical characteristics. The strength of this association was presented in odds ratio (OR) and 95% confidence interval (CI). The significance level adopted was 0.05. Mean age of the study population is 60 years old. 72.6% were male and 27.4% female. Symptoms of depression (mild to severe) were present in 88.4% of patients at baseline. Among the depressed patients, 22.6% of the cases were found to have for severe depression, 14.3% moderately-severe depressed, 15.5% moderately depressed, 27.4% for mildly depressed and 20.2% for minimally depressed. Depression at 30-day post discharge is more likely in women, diabetics and dialysis patients (p= 0.024, p < 0.001, p= 0.008 respectively). There was no difference in depression among ethnicity. Patients with baseline moderate to severe depression are more likely to have moderate to severe depression at 30 days (p < 0.001). Patients with low adherence to medications at 30 days reported moderate to severe depression at 30 days (p = 0.007). Baseline depression is the strongest predictor of 30-days depression. An increase in one unit of PHQ-9 baseline score increases the risk of developing severe depression after 30 days by 29%. There is no difference in terms of mortality between patients with significant depression and those without. Clinical depression is prevalent in our post-ACS patients. Associated factors are female gender, diabetics and dialysis patients. Depression at baseline predicts clinical depression at 30-days post discharge and is associated with low adherence to their medications. Thus we should actively screen for depression among ACS patients in order to administer appropriate treatment.