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Depressive symptoms and all-cause mortality in unstable angina pectoris (from the Coronary Psychosocial Evaluation

William Whang1, Daichi Shimbo, Ian M Kronish

  • 1Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York, USA.

The American Journal of Cardiology
|October 6, 2010
PubMed

Insights

Depression significantly increases mortality risk in unstable angina (UA) patients. Even mild depressive symptoms, measured by the Beck Depression Inventory (BDI), double the risk of death within 42 months.

Area of Science:

  • Cardiology
  • Psychiatry
  • Clinical Research

Background:

  • Depression is linked to higher mortality post-acute myocardial infarction.
  • Limited data exists on depression's impact on unstable angina (UA) patients.
  • Acute coronary syndrome (ACS) encompasses UA and myocardial infarction.

Purpose of the Study:

  • To investigate the association between depressive symptoms and all-cause mortality in UA patients.
  • To assess the prognostic value of depression severity in unstable angina.

Main Methods:

  • Prospective, multicenter study of 209 unstable angina patients.
  • Depressive symptoms assessed using Beck Depression Inventory (BDI) within 1 week of ACS event.
  • Patients categorized with BDI scores of 0-4 (low depression) or ≥10 (significant depression).

Main Results:

  • 50% of UA patients had significant depressive symptoms (BDI ≥ 10).
  • Multivariable analyses revealed a BDI score ≥ 10 was associated with a 2.04-fold increased risk of 42-month all-cause mortality (HR 2.04, 95% CI 1.20-3.46, p=0.008).
  • Adjusted for key clinical factors like LVEF, GRACE score, and Charlson comorbidity index.

Conclusions:

  • Significant depressive symptoms are linked to worse outcomes in unstable angina patients.
  • Findings confirm and extend previous research on depression and adverse events in ACS.
  • Interventions targeting depression warrant investigation across the ACS spectrum.

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