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Browsing by Author "Abdul-Mohsen, Mohammed"

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    Frequency of depression among patients with acute coronary syndrome, eastern region, Saudi Arabia
    (2004) Abdul-Mohsen, Mohammed
    Background:Three decades ago, Epidemiologists began to report a strong association between depression and cardiovascular disease - morbidity and mortality, and in the last decade, many large-scale studies have identified depression as an important risk factor for Coronary Artery Disease (CAD) and its morbidity and mortality. Objectives:To determine the frequency of clinical depression among patients admitted with Acute Coronary Syndrome (ACS) to the Coronary Care Unit (CCU) at King Fahd Hospital of the University (KFHU), and to find out if there is any relationship between depression and the traditional risk factors for CAD. Methods:One hundred and two patients admitted consecutively with ACS completed the self-rated Beck Depression Inventory (BDI) in their native language. The patients were classified into two groups: Group A comprising patients with no symptoms of depression and patients with subclinical or borderline depression, scored less than 21 points on BDI score scale; and Group B composed of those who scored 21 points and above. Various statistical tests were used whenever appropriate. Results:One hundred and two patients completed the BDI. Ninety-Two (90.2%) were males, with a mean age of 52.14΁12.14 years. Of these, 37.3% were Saudis, 25.5% Non-Saudi Arabs, 31.4% from the Indian subcontinent and 5.9% were other Asians. Patients from the Indian Subcontinent were significantly younger than the Saudis (p<0.0001). The evidence of clinical depression was found in 20.6% of all patients, 13.2% of Saudi patients, 19.2% of Non-Saudi Arabs and 34.4% of those from the Indian subcontinent. There was a significant difference in the frequency of clinical depression between Saudi patients and the Indians (p=0.035). Smoking and dyslipidemia were the only strong predictors of clinical depression in our study. Conclusion:Depression is unquestionably associated with CAD. Its frequency in our patients with ACS was 20.6%, and the highest frequency was recorded among patients from the Indian subcontinent (34.4%). Smoking and dyslipidemia were the strongest independent risk factors for depression.
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    Medical angioplasty - Hope and expectations: An optimistic overview
    (2011) Abdul-Mohsen, Mohammed
    Primary and secondary prevention of cardiovascular diseases (CVD) are markedly overlooked worldwide. The use of these kinds of preventive methods will greatly improve outcome of or even reverse major CVD, especially coronary atherosclerosis. Comprehensive lifestyle changes combined with aggressive medical therapy [lipid lowering agents "statins", antiplatelet agents, beta-blockers and angiotensin-converting enzyme inhibitors] for patients suffering from coronary heart disease significantly reduce all major adverse cardiovascular events (MACE), especially in those with stable coronary artery disease (CAD), even if their coronary lesions are significant. The main mechanistic pathways for the significant reduction of MACE are: Stabilization of atheromatous plaques through endothelial function reparation, strengthening of the fibrous cap of the atheromatous plaque and reduction of atheroma burden, i.e., reversal of the process of coronary artery stenosis, the great dream of "medical angioplasty". Despite the compelling data indicating the great beneficial effects of both primary and secondary prevention of coronary atherosclerosis, the US national survey data reveals that only a minority of patients eligible by guidelines for these therapies in fact receive them. Hence, we strongly believe that our main duties as cardiologists is to improve the up-to-date knowledge of the practicing physicians about utility of aggressive medical therapy for both prevention and reversal of CVD, and also to promote useful primary and secondary prevention programs among physicians and patients. Meanwhile, further improvement and refinement of the current therapeutic modalities and introduction of new modalities for the management of lipid parameters other than LDL-C, such as HDL-C, triglyceride, lipoprotein (a), LDL particle size and susceptibility to oxidation may add further favourable effects in prevention and reversal of atherosclerotic process. Cardiologists should be just as aggressive with prevention as many have been with intervention. This optimistic overview is a valley cry to all practicing physicians; please depart from usual methods of intervention to preventive strategies which are largely overlooked.