Study population collection
The study population comprises patients diagnosed with ACS at the Department of Cardiovascular Medicine in our hospital between June 2021 and December 2022, all of whom underwent PCI within one week of admission and are aged 60 years or older. Based on specific inclusion and exclusion criteria, we categorized the subjects into two groups, the study group, and the control group, according to their gender. The study group consisted of 113 randomly selected female patients while the control group comprised 121 randomly selected male patients. The Medical Ethics Committee of Ji’an Hospital approved all the experiments described herein.
Inclusion criteria
(1) Patients aged 60 years or older (2) Admitted to the Department of Cardiovascular Medicine at our hospital between June 2021 and December 2022 (3) Diagnosed with ACS (4) Underwent PCI within one week of admission (5) Met diagnostic criteria for acute coronary syndrome set by the World Health Organization and the International Society of Cardiology, including acute ST-segment elevation myocardial infarction, acute non-ST-segment elevation myocardial infarction, and unstable angina.
Exclusion criteria
Patients were excluded if they met any of the following criteria: (1) Language communication difficulties, altered consciousness, or severe physical illness preventing questionnaire completion (2) Severe heart failure, liver or kidney diseases, malignancies, respiratory failure, or relevant medical history (3) Psychiatric or neurological disorders, a confirmed family history or personal history of psychiatric illness, or a history of psychological trauma (4) Severe valvular heart disease, cardiomyopathy, severe arrhythmias, or cerebrovascular organic diseases (5) Acute or chronic infectious diseases, hematologic diseases, autoimmune diseases, or connective tissue diseases (6) History of trauma or other surgeries within the past three months (7) History of alcohol abuse and/or drug use (8) Illiteracy.
Data collection
General demographic data collection encompasses the acquisition of fundamental demographic information such as name, gender, age, marital status, educational attainment, occupation, family relationships, and economic status. The retrieval of laboratory and ancillary test findings for research subjects involves the assessment of various parameters, including blood pressure, heart rate, complete blood cell count, lipid profile, blood glucose, liver and kidney function assessments, cardiac enzyme concentrations, left ventricular ejection fraction measurements, chest X-ray interpretations, electrocardiogram results, and coronary angiography results. These results are classified based on coronary angiography as either indicative of single-vessel disease, double-vessel disease, or triple-vessel disease. Furthermore, they are classified based on PCI surgical outcomes, which are delineated as either surgical success or surgical failure.
Psychological disorder questionnaire assessment
The assessment of psychological disorders is conducted through a questionnaire distributed by specially trained personnel. These questionnaires are designed in-house and provided to both patients and their family members, who are given instructions on how to complete them. Importantly, all survey forms lack headings, thus respondents won’t be led by specific headings, allowing them to interpret the question more freely without preconceived notions and the questions focus on the subjective experiences and feelings of the respondents within the past week. The collected forms are then submitted within the designated time frame for statistical scoring and analysis.
Assessment with the SAS aims to gauge the test taker’s subjective experience of anxiety. It comprised a total of 20 items, each rated on a 4-point scale. The raw score is obtained by summing responses to all questions, and the standard score is calculated using the formula: Final Score = Raw Score × 1.25, rounded to the nearest whole number. Final scores falling within the range of 50–59 indicate mild anxiety, while scores between 60 and 69 indicate moderate anxiety. Scores exceeding 70 are indicative of severe anxiety. Assessment with the SDS offers an intuitive assessment of the subjective experiences with depressive symptoms. It comprised a total of 20 items, utilizing a scoring methodology and standard score calculation akin to that of the SAS calculation. The established cutoff value for SDS standard scores is 53 points, with scores ranging from 53 to 62 indicating mild depression, 63 to 72 indicating moderate depression, and scores surpassing 72 signifying severe depression.
Methodology
Anxiety and depression assessments using the SAS and SDS were administered to both the study group and the control group at four time points: before PCI, 1 week after PCI, 4 weeks after PCI, and 12 weeks after PCI. Raw scores were initially obtained from all questionnaire responses and subsequently transformed into final scores using the formula: Final Score = Raw Score × 1.25, rounded to the nearest whole number. Comparative analyses were performed to evaluate the overall health status between the study and control groups. Additionally, pairwise comparisons were executed to assess differences in SAS and SDS final scores in between the following time points: before PCI, 1 week after PCI, 4 weeks after PCI, and 12 weeks after PCI.
Statistical methods
Statistical analysis of the data acquired in this investigation was conducted using SPSS 23.0 software. Continuous data were expressed as mean ± standard deviation (x‾±s). Group comparisons for continuous data were carried out using Student t-tests, while comparisons for categorical data were conducted using χ2 tests. For multiple group comparisons, analysis of variance (ANOVA) was employed, with a significance threshold established at P < 0.05 to indicate statistical significance.
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