(CCSP013) FEMALE RISK FACTORS FOR POST-INFARCTION DEPRESSION AND ANXIETY: INTERVENTION (FRIDA-I) STUDY

Background: Female patients have higher rates of depression and anxiety following acute coronary syndrome (ACS), which is thought to contribute to adverse outcomes such as mortality and re-hospitalization. Improving depressive and anxious symptoms in female patients post-ACS has the potential to decrease associated adverse outcomes. Given that several studies have now demonstrated that female patients are significantly more likely than males to experience depression and anxiety post-ACS, and that females have a substantially higher mortality rate than males following acute myocardial infarction (47% vs. 36%), the intersection between mental health and cardiovascular outcomes in female patients must no longer be ignored.

METHODS AND RESULTS: The Female Risk factors for post-Infarction Depression and Anxiety – Intervention (FRIDA-I) study is a randomized control trial that will evaluate the impact of an online psychotherapy program on mental health outcomes in females six months post-ACS. Patients with high depression and/or anxiety scores (Hospital Anxiety and Depression Scale (HADS) score >7) are compared to age-matched controls. The control group will undergo usual care (UC), while the treatment group will participate in a six-week virtual psychoeducational (VP) program. Outcome measures will be administered at baseline (0 weeks), 3 weeks, completion of participation (64 weeks), and one month after completion (8 weeks). At each visit, the following will be administered: HADS, Cardiac Anxiety Questionnaire, Short Form-12 Health Survey, ENRICHD Social Support Instrument, and Somatic Symptom Scale. Over 500 patients have been recruited for the FRIDA cohort, of which 95 (20%) and 156 (32%) have elevated HADS-depression and anxiety scores, respectively. The modules feature diverse female characters and engaging, applicable exercises. Module topics include ACS information, cognitive behavioural therapy, mood changes post-ACS, coping strategies, future planning, thought records, and regionally-tailored resources. These modules will be implemented in female patients post-ACS with and without significant symptoms of mental distress in order to garner feedback and allow for implementation on a multi-center scale.

Conclusion: We anticipate that this comprehensive, inclusive, accessible, specific, and cost-effective virtual intervention will improve mental health outcomes in the post-ACS female population. The baseline characteristics of the FRIDA-I population notably show that those with high anxiety have a significantly higher proportion of unemployment, Indigeneity, history of mental health, and body mass index >30, while those with high depression have low social support, Indigeneity, history of mental health diagnoses, and non-white race, as compared to female patients with low HADS. The modules will be developed while considering these at-risk populations.