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Depression and cardiac morbidity 5 years after coronary artery bypass surgery
Louis Borowicz1, Richard Royall, Maura Grega
1Zanvyl Krieger Mind/Brain Institute, Department of Neurology, Johns Hopkins School of Public Health, Baltimore, MD 21287, USA. lborowil@jhmi.edu
Insights
Post-surgery depression after coronary artery bypass surgery (CABG) predicts future cardiac events. Depression one month after CABG is a key indicator of cardiac morbidity up to five years later.
Area of Science:
- Cardiology
- Psychiatry
- Health Outcomes Research
Background:
- Coronary artery bypass surgery (CABG) is a common procedure for advanced coronary artery disease.
- Postoperative depression is a recognized complication following major cardiac surgery.
- The long-term impact of early postoperative depression on cardiac health remains an area of investigation.
Purpose of the Study:
- To investigate the association between depression at one month post-coronary artery bypass surgery and cardiac morbidity five years later.
- To identify specific cardiac symptoms and patient factors linked to long-term cardiac outcomes after CABG.
Main Methods:
- Prospective cohort study involving patients undergoing coronary artery bypass surgery.
- Assessment of depression using the Center for Epidemiologic Studies Depression Scale at multiple time points (preoperative, 1 month, 1 year, 5 years).
- Evaluation of cardiac morbidity, including recurrence of angina, at the 5-year follow-up.
- Multivariable logistic regression analysis to identify significant predictors of cardiac morbidity.
Main Results:
- Depression one month after CABG was significantly associated with increased cardiac morbidity five years later.
- Recurrence of angina was the most prominent cardiac symptom affected by depression.
- Preoperative depression, male sex, and a history of smoking, percutaneous transluminal coronary angioplasty, or cerebrovascular accident were also linked to angina recurrence.
- The depression score at one month post-CABG emerged as the most significant predictor in multivariable analyses.
Conclusions:
- Depression detected one month after coronary artery bypass surgery is a crucial indicator of long-term cardiac morbidity.
- Early detection and management of postoperative depression may be vital for improving long-term cardiac outcomes in CABG patients.
- Integrating psychological assessments into postoperative cardiac care can enhance patient prognoses.
Abstract:
The purpose of this study was to determine whether depression 1 month after coronary artery bypass surgery would be associated with greater cardiac morbidity in patients 5 years later. The cardiac symptom most affected by depression was the recurrence of angina. Factors associated with a return of angina at 5 years were depression measured preoperatively, at 1 month, at 1 year, and at 5 years. Additional significant factors were male sex and a preoperative history of smoking, percutaneous transluminal coronary angioplasty, or cerebrovascular accident. When these factors were combined in multiple logistic regression analyses, the score on the Center for Epidemiologic Studies Depression Scale at 1 month was the most significant of all factors. The depression score at 1 month after coronary artery bypass surgery is an important indicator of cardiac morbidity up to 5 years later.
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