Qiping Zhou,1,* Qifan Liu,2,* Hui Yan,1,3,4 Yunyao Li,2– 4 Ayipali Abudureyimu,1 Shanshan Guo,2 Dan Tian,2 Guipeng Wang,5 Bing Huang2– 4 

1Department of Cardiology, Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China; 2Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China; 3Cardiovascular Research Institute, Wuhan University, Wuhan, People’s Republic of China; 4Hubei Key Laboratory of Cardiology, Wuhan, People’s Republic of China; 5Department of Geriatrics, Seventh Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Guipeng Wang, Department of Geriatrics, Seventh Affiliated Hospital of Xinjiang Medical University, No. 1986, Qidaowan South Road, Shuimogou District, Urumqi, Xinjiang Uygur Autonomous Region, 830017, People’s Republic of China, Email WFYWGP@163.com Bing Huang, Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, 99 Zhangzhidong Road, Wuchang District, Wuhan, Hubei, 430060, People’s Republic of China, Email, Email binghuang@whu.edu.cn

Background: A significant proportion of patients after percutaneous coronary intervention (PCI) have or develop comorbid depression and/or anxiety symptoms, which are associated with adverse events. The age, creatinine, and ejection fraction (ACEF) score is a good predictor for the prognostic assessment of certain cardiac diseases. But it has never been used to predict post-PCI depression and anxiety symptoms.
Aim: To evaluate the possible association among ACEF score at admission, post-PCI anxiety, depression, comorbid anxiety and depression symptoms in hospital.
Methods: After exclusion, a total of 222 patients undergoing emergency or selective PCI were enrolled and completed Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression symptoms before discharging. Patients were divided into four groups according to HADS score (anxiety, depression, comorbid anxiety and depression, neither anxiety nor depression). Logistic regression, linear regression and smoothed curve fitting (based on the penalized spline method) were used to analyze the relationship between ACEF score and post-PCI anxiety, depression symptoms. Receiver operating characteristic (ROC) curve analysis were performed to assess the value of ACEF score for predicting post-PCI anxiety, depression, comorbid anxiety and depression symptoms and to determine its critical values.
Results: Of the sample, the number of patients who were diagnosed with post-PCI anxiety, depression and comorbid anxiety and depression symptoms were 16 (7.2%), 33 (14.9%) and 37 (16.7%), which increased with the ACEF score quartiles. In multivariate-adjusted logistic regression analysis, the odds ratios (ORs) of post-PCI anxiety, depression symptoms were 7.701 (1.613– 36.766), 6.173 (1.608– 28.028) for the lowest quartile of ACEF score compared with the highest quartile. Multivariate-adjusted linear regression and smoothed curve fitting analysis demonstrated that post-PCI anxiety and depression scores increased with higher ACEF scores, indicating a nonlinear positive correlation. The ROC curve showed that ACEF score was a good predictor for post-PCI anxiety, depression and comorbid anxiety and depression symptoms.
Conclusion: Higher ACEF score is positively correlated with the prevalences of anxiety and depression symptoms after PCI in hospital, suggesting that ACEF score can be a valid predictor of depression and anxiety symptoms.

Keywords: ACEF score, post-PCI, depression, anxiety