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Published on: September 15, 2023
Risk of depression after coronary artery bypass grafting: a SWEDEHEART population-based cohort study
Malin Stenman1,2, Anders Jeppsson3,4, Aldina Pivodic5
1Perioperative Medicine and Intensive Care Function, Karolinska University Hospital, Anna Steckséns gata 41, 171 64 Stockholm, Sweden.
Insights
Patients undergoing coronary artery bypass grafting (CABG) face a higher risk of developing new-onset depression compared to the general population. This increased risk is particularly notable in younger patients within five years post-surgery.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Depression diagnosis in coronary heart disease patients correlates with poorer health outcomes.
- Understanding post-cardiac surgery mental health is crucial for patient recovery.
Purpose of the Study:
- To investigate the long-term incidence of new-onset depression following coronary artery bypass grafting (CABG).
- To compare depression risk in CABG patients versus a matched general population control group.
Main Methods:
- Utilized data from 125,418 primary isolated CABG patients and 495,371 controls (1992-2017).
- Employed Cox regression models to analyze adjusted risks for depression.
- Data sourced from the SWEDEHEART registry and national health registers.
Main Results:
- A higher cumulative incidence of depression was observed in CABG patients (6.1%) versus controls (4.7%).
- The adjusted risk of depression post-CABG was marginally increased (aHR: 1.05).
- Younger patients (<65 years) showed a more significant increased risk (aHR: 1.19), primarily within 5 years of surgery.
Conclusions:
- Coronary artery bypass grafting (CABG) is associated with an elevated risk of new-onset depression.
- Younger patients undergoing CABG require particular attention for depression screening in the initial post-operative years.
Aims:
A diagnosis of depression in patients with coronary heart disease is associated with worse outcomes. This study examined the long-term risk for new onset of depression after coronary artery bypass grafting (CABG) compared to an age- and sex-matched control group from the general population.
Methods And Results:
In total, 125 418 primary isolated CABG patients and 495 371 matched controls were included from 1992 to 2017. The SWEDEHEART registry and three other national registers were used to acquire information about baseline characteristics and depression. The adjusted risk of depression was estimated by using Cox regression models adjusted for patient characteristics, and socioeconomic variables, described by hazard ratios (HR) and 95% confidence intervals (CI). In total, 6202 (4.9%) CABG patients and 17 854 (3.6%) controls developed depression. The cumulative incidence of depression was higher in CABG patients than in the control population [6.1%, 95% CI 6.0-6.3 vs. 4.7% (4.7-4.8), P < 0.0001]. Overall, the CABG group had a marginally increased adjusted risk of depression compared to controls [adjusted HR (aHR): 1.05 (1.01-1.09), P = 0.0091]. In age-specific analyses, the increased risk compared to controls was only present in patients <65 years [aHR: 1.19 (1.11-1.27), P <0.0001] and was only evident during the first 5 years after surgery.
Conclusion:
Patients who underwent CABG had a higher risk of new onset of depression compared to sex- and age-matched controls in the general population. The risk of depression was especially pronounced in younger patients during the first 5 years after surgery.
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