Depression anticipates patients at risk of poor exercise stress test performance after percutaneous coronary

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Elisabetta Patron1, Simone Messerotti Benvenuti2, Andrea Ponchia3

  • 1Department of General Psychology, University of Padua, Padua, Italy.

General Hospital Psychiatry
|September 5, 2020
PubMed

Insights

Depressive symptoms negatively impact exercise stress test performance in patients after percutaneous transluminal coronary angioplasty (PTCA). Assessing depression is crucial for predicting physical capacity in these individuals.

Area of Science:

  • Cardiology
  • Psychosomatic Medicine
  • Rehabilitation

Background:

  • Exercise stress testing is vital for assessing recovery in coronary artery disease (CAD) patients post-percutaneous transluminal coronary angioplasty (PTCA).
  • Depressive symptoms are linked to adverse outcomes in CAD but are often overlooked as predictors of exercise test performance.
  • The influence of psychological factors on exercise capacity in PTCA patients requires further investigation.

Purpose of the Study:

  • To investigate the impact of depressive symptoms on exercise stress test outcomes in patients following PTCA.
  • To determine if anxiety, sleep problems, and perceived health also affect exercise test performance in this population.

Main Methods:

  • 165 patients undergoing PTCA completed validated questionnaires for depression (Beck Depression Inventory-II), anxiety, sleep quality, and perceived health.
  • Patients subsequently underwent an exercise stress test approximately 20 days after PTCA.
  • Statistical analyses controlled for sociodemographic and biomedical risk factors.

Main Results:

  • Higher depression scores significantly predicted lower maximal workload (METs) and shorter exercise duration.
  • Depression also predicted the inability to reach maximum heart rate during the test.
  • These associations remained significant after adjusting for other risk factors.

Conclusions:

  • Depressive symptoms are a significant independent predictor of poorer exercise stress test performance in patients post-PTCA.
  • Routine assessment of depression, alongside traditional risk factors, is essential for identifying patients at risk of diminished physical capacity.
  • This highlights the importance of addressing psychological well-being in cardiac rehabilitation.
Abstract

Keywords:
Coronary artery diseaseDepressive symptomsExercise stress testsPercutaneous transluminal coronary angioplasty

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