Post-SCAD Depression and Anxiety

Depression and anxiety after myocardial infarction (MI) are common, and are associated with increased rates of illness and death. However, MIs caused by arterial plaques differ dramatically from MIs caused by SCAD in terms of which populations are affected, the resources available to them, and their functional changes and outcomes. Associations between SCAD and depression and anxiety are unknown; this project aims to determine the prevalence and predictors of depression and anxiety in SCAD survivors.

In this cross-sectional study, SCAD survivors are surveyed to screen for depression and anxiety. Symptoms of mental and physical health are included in the surveys, as are environmental, socio-economic, and clinical cardiovascular characteristics.

In the initial review of the data, 33 percent of SCAD registry participants have received treatment for depression with medications or counseling since their initial SCAD MI, and 37 percent have received similar treatment for anxiety. About 32 percent report taking antidepressant or anxiolytic medications. Overall, mean survey scores suggest borderline mild depression, anxiety or both. Younger age appears to be associated with higher scores, as does occurrence of SCAD in the period before or after giving birth. Participants who were treated with percutaneous coronary intervention have lower scores.

Our initial conclusion is that symptoms of depression and anxiety are common in patients with MI due to SCAD, particularly younger women and those with peripartum SCAD. Trial assessments may detect depression or anxiety in SCAD survivors who do not self-report these disorders, suggesting a role for routine screening in these patients.

Initial findings from this project have been published. Research in this area is ongoing.