Unignorable influence of chest pain on mood symptoms and prognostic values in coronary artery disease: a cross-sectional study

Prior researches studying depression and anxiety among individuals with coronary artery disease (CAD) have predominantly concentrated on the connection with clinical and laboratory indicators, disregarding the impact of the cardinal symptom—chest pain. In this cross-sectional study with 561 consecutive CAD inpatients enrolled, the prevalence of mood symptoms/disorder and the influence of chest pain on depression and anxiety symptoms and their prognostic effects in a median follow-up period of 26 months were investigated. The prevalence of having depression and anxiety symptoms reached 37.6% and 27.3%, respectively. Comprehensive analyses revealed that the primary correlated factors for depression were chest pain frequency, age, history of diabetes, and exercise time, and for anxiety were chest pain frequency, chest pain course, and education level. As the common and strongest predictor, chest pain frequency demonstrated a dose-dependent relationship with the risk for mood symptoms. Chest pain frequency and course were not directly associated with prognosis, however impact the prognostic effect of mood symptoms. The association between major adverse cardiovascular events (MACEs) and depression symptoms was primarily observed in patients with a high chest pain frequency, whereas with anxiety was mainly presented in patients with a short chest pain course. For noncardiac rehospitalization, anxiety presented higher predictive value in participants with low chest pain frequencies, while depression was right the opposite. In conclusion, CAD patients with mood symptoms who experience frequent chest pain episodes despite a short course warrant special attention. Enhancing their emotional well-being and addressing chest pain symptoms might potentially yield valuable clinical benefits.