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Association of depression with adverse cardiovascular events after percutaneous coronary intervention

Zhi Jian Wang1, Min Guo, Tian Mei Si

  • 1aDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University bDepartment of Clinical Psychopharmacology, Institute of Mental Health, Peking University cThe Key Laboratory for Mental Health, Ministry of Health dZhongguancun Hospital, Beijing eAffiliated Hospital of Jilin Medical College, Jilin, China.

Coronary Artery Disease
|August 14, 2013
PubMed

Insights

Depression is common in patients undergoing percutaneous coronary intervention (PCI). Postprocedure depression independently predicts major adverse cardiovascular events (MACE), including mortality and repeat revascularization, within three years.

Area of Science:

  • Cardiology
  • Psychiatry
  • Clinical Medicine

Background:

  • Coronary artery disease (CAD) is a leading cause of mortality worldwide.
  • Percutaneous coronary intervention (PCI) is a common revascularization procedure for CAD.
  • The psychological impact of CAD and PCI on patient outcomes requires further investigation.

Purpose of the Study:

  • To determine the prevalence of depression in patients undergoing PCI.
  • To assess the association between depression and clinical outcomes after PCI.
  • To identify depression as a predictor of adverse cardiovascular events post-PCI.

Main Methods:

  • A cohort of 400 patients undergoing PCI were evaluated for depression using the Mini-International Neuropsychiatric Interview before and after the procedure.
  • Patients were followed for three years to track major adverse cardiovascular events (MACE), including mortality, nonfatal myocardial infarction, and repeat revascularization.
  • Statistical analyses were performed to determine the impact of depression on MACE and its components.

Main Results:

  • Post-PCI depression was diagnosed in 38.5% of patients, a significant increase from pre-PCI rates (25.5%).
  • Patients with post-PCI depression exhibited higher rates of MACE (27.3% vs. 13.0%), mortality (5.8% vs. 2.0%), and repeat revascularization (13.0% vs. 6.5%) over three years.
  • Post-PCI depression was an independent predictor of 3-year MACE (HR: 2.51), mortality (HR: 3.60), and repeat revascularization (HR: 2.22) after adjusting for confounding factors.

Conclusions:

  • Depression is a prevalent comorbidity in patients undergoing PCI.
  • Post-PCI depression is a significant and independent predictor of adverse cardiovascular outcomes, including mortality and the need for repeat revascularization.
  • Routine screening for depression in PCI patients is warranted to improve long-term clinical outcomes.
Abstract

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