(CCSP106) INVESTIGATING RISK FACTORS ASSOCIATED WITH MENTAL HEALTH SYMPTOMS AMONG WOMEN WITH CORONARY VASOSPASM OR MICROVASCULAR DYSFUNCTION

Background: Depression and anxiety are considered modifiable risk factors that have been shown to associate with a higher risk of ischemic heart disease (IHD), with higher relative effect sizes in women than men. Depression and anxiety portend elevated risk in developing vasomotor etiologies of IHD, including vasospasm and coronary microvascular dysfunction (CMD). The aim of this work was to investigate changes in mental health symptoms reported in patients with vasospasm or CMD who participated in a women's heart clinic for 3 years, and to explore the effect of select variables on these changes.

METHODS AND RESULTS: We included female patients with a diagnosis of vasospasm or CMD enrolled in the Leslie Diamond Women’s Heart Health Clinic Registry in Vancouver, Canada. The Patient Health Questionnaire (PHQ-9) was administered at baseline and 3 years to capture mental health symptoms. Select baseline variables associated with mental health status in women were investigated: age, menopausal status, history of migraines, baseline diagnoses of depression and/or anxiety, visits with WHC-affiliated psychiatrist, and working status. Chi-squared or Fisher’s tests compared discrete variable frequencies between diagnoses. Paired Wilcoxon rank sum tests compared mean PHQ-9 scores between timepoints.

111 patients with diagnoses of vasospasm (n=35) or CMD (n=76) completed baseline and 3-year questionnaires. Women with vasospasm were significantly younger than women with CMD (53 vs. 61 years, p < .001), more were pre- or peri-menopausal (51% vs 18%, p < .001), and more had migraines (51% vs 18%, p < .001) (Table 1). No significant differences were observed between diagnoses for depression and/or anxiety, psychiatrist visits, or working status.

Women with CMD had significantly improved self-reported mental health after 3 years of attendance at the WHC irrespective of baseline depression and/or anxiety diagnoses and menopausal status (Figure 1). In women without migraines, there were also significant improvements in mental health symptoms, while the improvements seen in the small number of women with migraines were not statistically significant. None of the changes in PHQ-9 scores observed in patients with vasospasm were significant, regardless of baseline depression and/or anxiety diagnoses, menopausal or migraine status.

Conclusion: Participation in a WHC provides significant improvements in mental health symptoms amongst women with CMD irrespective of baseline depression and/or anxiety diagnosis or menopausal status. Similar improvements were not observed in those with vasospasm. Future investigations will examine which particular aspects of WHC attendance most significantly impact subjective wellbeing in patients living with coronary vasospasm or CMD.