Factors associated with depression and anxiety in people who have suffered an acute myocardial infarction and undergone revascularization via percutaneous coronary intervention: a cross-sectional study

Abstract

Acute myocardial infarction (AMI) is a cardiovascular event that has a significant clinical, functional, and emotional impact. Patients may experience anxiety and depression that could influence their recovery. This study aimed to identify the association between various biopsychosocial factors and anxiety and depression levels in patients with AMI who underwent percutaneous coronary intervention (PCI) and were enrolled in a cardiac rehabilitation program (CRP). This observational, cross-sectional study was a secondary analysis of data from the CARDIOINSPIRE clinical trial, conducted at the Virgen de la Victoria University Hospital in Málaga, Spain. Eligible patients were people diagnosed with AMI who underwent PCI and referred to a CRP. Measurements were obtained at baseline assessment of the CRP. Associations between anxiety and depression levels and health-related quality of life, sleep quality, perceived social support, and physical activity level were examined using Pearson or Spearman correlations and multiple linear regression models using IBM SPSS v.29 software. A total of 72 patients (mean age 57.86 ± 8.91 years; 51.4% male, 48.6% female) were analyzed. The mean anxiety score (8.84 ± 5.31) fell within the doubtful-case range, whereas the mean depression score (7.28 ± 5.31) approached the threshold for clinical relevance. A strong positive association was found between anxiety and depression ( r = 0.799, p < 0.001). Both outcomes were strongly and negatively correlated with the mental component of health-related quality of life (anxiety r = − 0.751; depression r = − 0.778; both p < 0.001). Sleep quality showed a moderate-to-strong positive correlation with both anxiety ( r = 0.565, p < 0.001) and depression ( r = 0.621, p < 0.001). Perceived social support was negatively associated with anxiety ( r = − 0.496, p < 0.001) and depression ( r = − 0.577, p < 0.001). A lower aerobic physical activity level was associated with higher anxiety scores ( r = − 0.247; p = 0.046). Patients with AMI who underwent PCI and assessed prior to initiating a CRP appeared to present a relevant psychological burden at intervention entry, with anxiety scores in the doubtful-case range and depression scores at borderline values. Poorer sleep quality, lower perceived social support, and reduced aerobic physical activity emerged as potentially relevant biopsychosocial correlates of both outcomes. These findings may support incorporating a comprehensive biopsychosocial assessment at cardiac rehabilitation entry to identify vulnerable patients and guide interdisciplinary recovery approaches. ClinicalTrials.gov, NCT06681740. Registered 11/07/2024.

The authors' abstract, as published at the source. BMC Cardiovascular Disorders, 2026 · DOI ↗