title: Association between anxiety and depression in patients with acute coronary syndromes due to financial crisis.
abstract: BACKGROUND
  The effect of anxiety and depression on patients with acute coronary syndromes (ACS) warrants investigation, especially during periods of economic crisis.
  
  
  OBJECTIVE
  To investigate the relation between anxiety and depression in patients presenting with ACS due to financial crisis and to investigate whether these two entities could predict long-term cardiovascular mortality.
  
  
  RESULTS
  Anxiety and depression symptoms were assessed in 350 patients (210 men) presenting with ACS, with 70 (20%) patients showing elevated scores (Hellenic Heart Failure Protocol). Over a mean follow-up of 48 months there were 36 (10%) cardiovascular deaths. Cox proportional hazards models adjusted for other prognostic factors (including age, sex, marital status, creatinine levels, left ventricular ejection fraction, heart failure, atrial fibrillation, previous hospitalisation, and baseline medications) showed that elevated anxiety and depression scores significantly predicted cardiovascular mortality (primary outcome) and all-cause mortality.
  
  
  CONCLUSIONS
  Elevated anxiety and depression symptoms are related to cardiovascular mortality due probably to financial crisis, even after adjustment for other prognostic indicators in patients with ACS, who received optimised medical treatment.
authors.forename: Kostandinos
authors.initials: K
authors.lastname: Lampropoulos
authors.affiliation: Evaggelismos Genaral hospital. kavourasch@yahoo.gr.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Kavvouras
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Megalou
authors.forename: Pinelopi
authors.initials: P
authors.lastname: Tsikouri
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Kafkala
authors.forename: Dimitra
authors.initials: D
authors.lastname: Derka
authors.forename: Maria
authors.initials: M
authors.lastname: Bonou
authors.forename: John
authors.initials: J
authors.lastname: Barbetseas
mesh_terms: D054058:Acute Coronary Syndrome / Q000191:economics / Q000401:mortality / Q000523:psychology*; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000191:economics*; D003863:Depression / Q000191:economics*; D057172:Economic Recession; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: acute coronary syndromes; anxiety; depression