Study of influence of depression on assessment of cardiovascular risk in IHD patients with components of metabolic syndrome (MS).

Among 376 IHD patients (59,1±10,3 years) 72,9% had AH, 40,2% DM of type 2 or disturbance of tolerance to glucose (DTG), 45,9% obesity, 42,2% dyslipidemia (DLP). Methods of investigation were as follows: clinicalpsychopathological, experimental-psychological, HADS, MADRS.

Depressive disorders have been diagnosed in 109 IHD patients (29%) of cardiologic institution. 79,8% had affective disorders, 20,2% mixed anxiety-depressive reaction, organic depressive disorder. There were more often factors of cardiovascular risk and components of MS: frequency of AH (83,2% vs. 66,3%; p = 0,016), DM of type 2 and DTG (46,8% vs. 37,5%; p = 0,048), obesity (30,7 ± 3,9 vs. 29,5 ± 4,5; p = 0,015), abdominal obesity (100,0 ± 10,7 vs. 92,0 ± 9,6 cm; p = 0,02), DLP (42,2% vs. 31,1%; p = 0,04); TCh (6,03 ± 1,19 vs. 5,72 ± 1,31 mmol/l; p = 0,033); Ch-LPHD (0,83 ± 0,18 vs. 0,94 ± 0,29 mmol/l; p = 0,0015). We have noticed increase of cases of instable angina (16,5% vs. 8,2%; p = 0,02), post-infarction cardiosclerosis (41,3% vs. 39,3%; p = 0,043), surgical revascularization of myocardium (22,9% vs. 15,4%; p = 0,041), need for nitrates (23,4 ± 2,8 vs. 17,6 ± 2,9 tablets/week; p = 0,00001), invalidization (44% vs. 23,2%; p = 0,00001). During intake of antidepressants (SSRIs) higher scores according to depression rating scales remained by month 6 of psychotropic therapy.

High frequency of association of factors of cardiovascular risk and components of MS in IHD patients with depressive disorders significantly exceeds indices in group without depression. Metabolic disturbances (DM of type 2, DTG, DLP), revealed in 65,1% of IHD patients with depression, decrease efficacy of antidepressant therapy.