Related Experiment Video
Updated: Aug 2, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Association between preoperative depression and long-term survival following coronary artery bypass surgery - A
Malin Stenman1, Martin J Holzmann2, Ulrik Sartipy1
1Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Insights
Preoperative depression increases long-term mortality risk in patients undergoing coronary artery bypass grafting (CABG). Screening for depression before cardiac surgery can identify high-risk individuals for better outcomes.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Depression is prevalent in cardiovascular disease patients.
- The impact of preoperative depression on long-term survival after coronary artery bypass grafting (CABG) requires further investigation.
Purpose of the Study:
- To determine the association between preoperative depression and long-term survival in adults undergoing CABG.
Main Methods:
- Systematic literature search of multiple databases (PubMed, EMBASE, etc.) up to November 2015.
- Included cohort studies with at least one-month follow-up reporting hazard ratios (HR) and 95% confidence intervals (CI).
- Random-effects meta-analyses were used to calculate pooled HR for all-cause mortality.
Main Results:
- Seven studies with 89,490 patients (4002 depressed) were analyzed.
- A pooled hazard ratio of 1.46 (95% CI: 1.23-1.73) indicated increased all-cause mortality risk for depressed patients.
- Moderate heterogeneity was observed (I²=50.1%).
Conclusions:
- Preoperative depression is linked to a higher risk of long-term all-cause mortality post-CABG.
- Systematic depression screening before cardiac surgery is recommended to identify at-risk patients.
Background:
Depression is common in patients with cardiovascular disease. The importance of preoperative depression for long-term survival following coronary artery bypass grafting (CABG) is not well known. The aim was to provide a summary estimate of the association between preoperative depression and long-term survival in adults who underwent CABG.
Methods:
We did a systematic search of MEDLINE, EMBASE, Cochrane Library, PsycINFO, Web of Science, and PubMed from inception to November, 2015, including cohort studies with at least one month of follow-up that reported hazard ratios (HR) and 95% confidence intervals (CI) for long-term all-cause mortality following CABG in patients with preoperative depression compared to non-depressed patients. Two reviewers independently extracted data on populations, exposure, outcome, risk of bias, and quality of evidence. We calculated HR and 95% CIs for all-cause mortality using random-effects meta-analyses and performed subgroup and sensitivity analyses.
Results:
Seven studies were included with a combined study population of 89,490 patients (4002 depressed/85,488 non-depressed). All studies observed a positive association between preoperative depression and all-cause mortality, and in 4 studies the association was statistically significant. Patients with depression had a pooled hazard ratio of 1.46 (95% CI: 1.23-1.73, p<0.0001) for all-cause mortality with moderate heterogeneity (I(2)=50.1%, p=0.061).
Conclusions:
This systematic review and meta-analysis indicates that patients with preoperative depression are at increased risk for long-term, all-cause mortality following CABG compared with those without depression. Systematic screening for depression prior to cardiac surgery could identify those at higher risk.
