Qualidade de vida, ansiedade e depressão após infarto do miocáridio

Abstract

The Acute Myocardial Infarction (AMI) is a vascular disease that generally results from the aterosclerotic process with thrombotic occlusion of the coronaries. This acute situation unbalances the offer and consumption of oxygen, leading to a necrosis of the tissue. Due to the higher number of AMI survivors, we tend to be more concerned about clinical care, what motivates the search for methods that enable an objective and quantitative assessment of the quality of life, anxiety and depression. These factors must be particularly focused during medium and long-term treatments. We also need to compare the various types of treatment presently used in post-infarction, especially the percutaneal or surgical revascularization and the clinical treatment, with the aim of choosing the ones which are more efficient and present more correlation with a better quality of life, with lower levels of anxiety and depression. The purpose of this study is to evaluate the quality of life, anxiety and depression in patients after acute myocardial infarction (AMI), through the application of Mac New QLMI, IDATE and BDI questionnaires, respectively, and confront them to risk factors and the kind of treatment established before the recruitment. We evaluated 59 patients, being 46 (78%) males and 13 (22%) females, with an average age of 57,70 +/- 6,96, selected from the medical file of the Clinics Hospital of the Federal University of Uberlândia, MG. All of them presented an AMI episode before the evaluation started. The questionnaires were firstly applied in August 2003, and reapplied in August 2004. The results were analyzed through descriptive techniques, using also the Pearson and the Spearman correlation coefficients. The results demonstrate that: a) there was a reduction in anxiety and depression levels added to a worsening in life quality between the two evaluations; b) stress and tobaccoism positively correlated with the existence of depression; c) the arterial hypertension and the medicamental treatment showed correlations with a higher anxiety only in the first evaluation; d) the worsening in life quality was correlated with tobaccoism, in the first evaluation, and with the presence of dislipidemy, after twelve months; e) depression showed significant correlation with the black race and widowhood. These results showed the necessity of accompanying these patients through special rehabilitation programs, with multidisciplinary scope and with protocols, established trough a clinical approach, but always followed by an evaluation of life quality, anxiety and depression, which deserve special attention from the team.