ABC | Volume 111, Nº5, November 2018

Original Article Serpytis et al Anxiety and depression after myocardial infarction Arq Bras Cardiol. 2018; 111(5):676-683 Table 1 – Emotional disorder presentation in both genders Emotional disorder Men Women χ 2 or β p value Any emotional disorder Prevalence n = 61 60.4% n = 48 81.4% χ 2 = 7.54 0.006* Odds ratio 1 2.861 (1.33 – 6.16) β = 1.05 0.007* Anxiety disorder Prevalence n = 40 39.6% n = 38 64.4% χ 2 = 9.17 0.002* Odds ratio 1 2.760 (1.42 – 5.37) β = 1.02 0.003* Depression disorder Prevalence n = 48 47.5% n = 32 54.2% χ 2 = 0.67 0.413 Odds ratio 1 0.764 (0.4 – 1.46) β = 0.269 0.413 Both depression and anxiety disorders Prevalence n = 27 26.7% n = 22 37.3% χ 2 = 1.95 0.162 Odds ratio 1 1.630 (0.82 – 3.24) β = 0.49 0.164 *Significant p values. Odds ratio reported as odds ratio (95% confidence interval). Table 2 – Prevalence of anxiety and depression based on gender and severity Severity of anxiety/ depression Hospital Anxiety and Depression Scale (HADS) Anxiety subscale Depression subscale Total Men Women p value Total Men Women p value n % n % n % n % n % n % No disorder 82 51.3 61 60.4 21 35.6 0.002* 80 50 53 52.5 27 45.8 0.413 Mild disorder 39 24.4 18 17.8 21 35.6 0.012* 43 26.9 25 24.8 18 30.5 0.428 Moderate disorder 30 18.8 16 15.8 14 23.7 0.217 27 16.9 17 16.8 10 16.9 0.985 Severe disorder 9 5.6 6 5.9 3 5.1 0.821 10 6.3 6 5.9 4 6.8 0.832 Total 82 51.3 61 60.4 21 35.6 0.002* 80 50 53 52.5 27 45.8 0.413 *Significant p values (between men and women, χ 2 ). There was no significant association between patient age and anxiety severity. However, a weak positive significant correlation was found between patient age and depression severity (p = 0.233, p = 0.003). In addition, it was determined that male patients who developed depression were on average younger than those without the disease, with a mean age of 58 years and 66 years, respectively (p = 0.005). The age with the highest risk of developing depression was determined to be between 55 and 62 years of age for males, whilst 95% of female patients who developed depression were between 66 and 75 years of age. A subsequent gender-based analysis showed that there was a significant weak positive correlation between male patient age and depression severity (p = 0.212, p = 0.033) and a weak negative correlation between male patient age and anxiety severity (p = - 0,278, p = 0.005). In contrast, the data analysis in women did not demonstrate any statistical association, thus meaning that depression and anxiety severity is similar for women of all age after MI. (Table 3) Cardiovascular risk factor analysis showed an association between diabetes mellitus and HADS-D score in males who had a significantly higher median depression score compared to those who were not diabetic (10, IQR 5 – 11 vs. 5, IQR 3 – 9.75, p = 0.043). In contrast, female patients did not show any significant association between diabetes mellitus and emotional disorders. Hypercholesterolemia was associated with both higher median anxiety (8, IQR 6 – 12 vs. 6.5, IQR – 4 – 8, p = 0.02) and depression (9, IQR 7 – 12 vs. 7, IQR 4 – 8.75, p = 0.015) scores in women, while men did not show any association between the aforementioned factors (Table 4). Moreover, it was determined that arterial hypertension and body mass index were not, in any way, associated with anxiety or depression. The evaluation of patient smoking habits revealed that 15.6% of respondents were daily smokers (Table 3). Smoking was more prevalent amongst men than women (20.8% vs. 6.8%, p = 0.019). Furthermore, a higher HADS-A score was identified in male patients who did smoke (10, IQR 7.5 – 14) vs. 6.5, IQR 3 – 9, p = 0.002), whilst the HADS-A score did not differ between women who smoked or did not smoke (p = 0.311). Likewise, there was no statistically significant difference in the HADS-D subscale scores between smoking and non-smoking patients. Exercise habit analysis showed that the group of patients who did not exercise had a higher median HADS-D score than the group that exercised (9, IQR 6 – 12 vs. 5, IQR 3 – 9, p < 0.001). Gender-based 678