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Depression predicts the risk of adverse events after percutaneous coronary intervention: A meta-analysis

Xueqin Song1, Junxian Song2, Mingjing Shao3

  • 1The First Affiliated Hospital Zhengzhou University, Biological Psychiatry International Joint Laboratory of Henan/Zhengzhou University, Henan Psychiatric Transformation Research Key Laboratory/Zhengzhou University, Zhengzhou, 450052, China.

Journal of Affective Disorders
|February 15, 2020
PubMed

Insights

Depression significantly increases risks for major adverse cardiovascular events and all-cause mortality in patients after percutaneous coronary intervention (PCI). Early intervention for depression in these patients is crucial for better cardiac outcomes.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Depression is a known factor associated with poorer outcomes in patients diagnosed with coronary artery disease (CAD).
  • The impact of depression on cardiovascular events and mortality following percutaneous coronary intervention (PCI) requires thorough investigation.

Purpose of the Study:

  • To conduct a meta-analysis assessing the association between depression and the risks of major adverse cardiovascular events (MACEs) and all-cause mortality.
  • To evaluate the influence of depression on patient prognosis after undergoing PCI.

Main Methods:

  • A systematic literature search was performed on PubMed and Embase databases to identify relevant cohort studies.
  • Data from nine cohorts, including 4,555 patients who underwent PCI (1,108 with depression), were analyzed using fixed- or random-effect models based on heterogeneity.
  • Adjusted risk ratios (RR) were calculated to compare MACEs and all-cause mortality in patients with and without depression.

Main Results:

  • The meta-analysis revealed that depression is linked to a significantly higher risk of MACEs (RR: 2.10) and all-cause mortality (RR: 1.76) in patients post-PCI.
  • No significant heterogeneity was detected among the included studies for MACEs (I² = 25%) and mortality risks (I² = 0%).
  • These findings were consistent across the analyzed cohorts, underscoring the independent association.

Conclusions:

  • Depressive symptoms are independently associated with adverse cardiovascular outcomes, including MACEs and mortality, in patients who have undergone PCI.
  • The study suggests that psychological therapies, avoiding cardiac burden or side effects, may be beneficial for managing depression in this patient population.
  • Further research may explore specific interventions to mitigate the risks associated with depression in post-PCI patients.
Abstract

Keywords:
Coronary artery diseaseDepressionMajor adverse cardiovascular eventsMortalityPercutaneous coronary intervention

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