INTRODUCTION:
Coronary Artery Disease is an important cause of morbidity and mortality
in the world. Clustering of chronic diseases is common in patients with
coronary artery disease (CAD). Chronic diseases such as diabetes,
hypertension, dyslipidemia etc., have been well studied in the context
of CAD. However, psychiatric co-morbidity especially depression and
anxiety, is frequently overlooked in these patients. The proportion of
CAD patients suffering from psychiatric co-morbidity is not
insignificant. Previous studies have reported the prevalence of
depression to be about 20-40% in patients with CAD(1). Similarly,
anxiety has been reported in 20-30% of patients following an acute
coronary syndrome (ACS)(2,3).Psychiatric co-morbidity has also found to
be prevalent in cardiovascular disorders other than CAD. Depression and
anxiety in chronic cardiovascular conditions such as chronic heart
failure (CHF) are being increasingly recognized(4,5).
Patients of CAD referred for coronary artery bypass graft (CABG) surgery
constitute a special population. Most of these patients are limited in
their activity by angina which is attributable to their multivessel
coronary artery disease. In addition, these patients are confronted with
the problem of polypharmacy due to multiple antianginal medications
apart from other agents which include but are not limited to
antiplatelets, statins, antidiabetic and antihypertensive medications.
Compounding these issues is the stress of an impending major surgery.
All of these factors may add significantly to the burden of psychiatric
co-morbidity in this specific group of patients. Pre-operative
depression and anxiety have been shown to be associated with worse
outcomes post CABG surgery(6–9). In addition, untreated depression and
anxiety hamper efforts at complete cardiac rehabilitation following
CABG. Identification of co morbid psychiatric disorders is therefore of
vital importance in patients undergoing CABG surgery. With an increasing
burden of CAD in developing countries, there has been a rise in the
number of CABG surgeries performed each year. Nearly 150,000 CABG
surgeries are performed in India every year. Despite these large
numbers, there is little available Indian data on the prevalence of
depression and anxiety in patients undergoing CABG surgery. The present
study was performed to determine the prevalence of depression and
anxiety in Indian patients undergoing CABG surgery and their
relationship to physical activity and quality of life.