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Angina Severity, Depression, and Response to Percutaneous Revascularization in Patients With Chronic Total Occlusion

Jeffrey T Bruckel, Farouc A Jaffer, Cashel O'Brien

  • 1Cardiology Division, Massachusetts General Hospital, 55 Fruit St, Boston MA 02114 USA.

The Journal of Invasive Cardiology
|October 19, 2015
PubMed

Insights

Depression is prevalent in patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Depressed patients experienced significantly greater angina relief after CTO-PCI, highlighting the need for depression screening.

Area of Science:

  • Cardiology
  • Psychiatry
  • Interventional Cardiology

Background:

  • Depression is common in chronic angina patients, associated with poor outcomes.
  • Chronic total occlusions (CTOs) are a frequent cause of angina.
  • The interplay between angina, depression, and CTO intervention requires investigation.

Purpose of the Study:

  • To determine depression prevalence in patients referred for CTO percutaneous coronary intervention (PCI).
  • To evaluate the association between depression and baseline angina severity.
  • To compare angina symptom improvement post-CTO-PCI in depressed versus non-depressed individuals.

Main Methods:

  • Prospective data collection from 45 consecutive patients undergoing CTO-PCI (Oct 2013-Oct 2014).
  • Assessment of angina using the Seattle Angina Questionnaire (SAQ7).
  • Evaluation of depression status via the Patient Health Questionnaire (PHQ-2).

Main Results:

  • 40% of patients (18/45) presented with depression at baseline.
  • Depressed patients reported significantly higher baseline angina burden (SAQ7 scores) than non-depressed patients (P<.001).
  • Following CTO-PCI, depressed patients showed substantially greater improvement in angina symptoms (SAQ7 scores) compared to non-depressed patients (P<.001).

Conclusions:

  • Depression is linked to greater angina limitation and predicts a more favorable response to CTO-PCI.
  • A significant proportion (67%) of CTO patients were undiagnosed or untreated for depression.
  • Routine depression screening is recommended for patients with CTO.
Abstract

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