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.