The association between psychological symptoms, sleep quality and severity of coronary artery disease in acute coronary syndrome.

Background: There are few studies on the relationship between psychological disorders, sleep quality and coronary artery disease (CAD) severity in acute coronary syndrome (ACS).

Aim: Our aim was to clarify the relation between CAD severity, psychological symptoms, and sleep quality in patients with ACS.

Methods: This is a prospective, single-center, hospital-based study, and 151 patients with ACS between 1st March and 1st September 2021 were included in the study. Symptom Checklist-90-Revised (SCL-90-R) and Pittsburgh Sleep Quality Index (PSQI) tests were applied to the patients. The study population consisted of two groups; mild CAD group (SS ≤ 22) and severe CAD group (SS > 22) based on the SYNTAX score (SS), and their SCL-90-R and PSQI scores were compared.

Results: The median age of all patients was 60 (40-85) years. 83 patients (55%) were male. SCL-90-R anxiety score (p = 0.013), depression score (p = 0.024), hostility score (p = 0.028), additional scale score (p = 0.028), and PSQI score (p < 0.001) were statistically significantly higher in the severe CAD group. In binary logistic regression analyses of all psychological features and sleep status, the PSQI score (p < 0.001) was independently associated with severe CAD in ACS.

Conclusions: This study pointed out that anxiety, depression, hostility symptoms, and poor sleep quality were more common in the severe CAD group in patients with ACS when evaluated in terms of all psychological characteristics. Unlike all psychological disorders, poor sleep quality was observed to be independently associated with severe CAD in ACS.