Related Experiment Videos
Ventricular tachycardia and psychiatric depression in patients with coronary artery disease
R M Carney1, K E Freedland, M W Rich
1Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110.
Insights
Depression significantly increases the risk of ventricular tachycardia (VT) in patients with coronary artery disease (CAD). This finding highlights the importance of addressing mental health in cardiac care to reduce mortality risks.
Area of Science:
- Cardiology
- Psychiatry
- Clinical Medicine
Background:
- Coronary artery disease (CAD) is a leading cause of mortality.
- Psychiatric depression is increasingly recognized as a comorbidity in CAD patients.
- The link between depression and adverse cardiac events requires further elucidation.
Purpose of the Study:
- To investigate the association between psychiatric depression and ventricular arrhythmias.
- To determine if depressed patients with CAD exhibit a higher prevalence of ventricular tachycardia (VT).
Main Methods:
- 103 patients with significant CAD underwent psychiatric interviews and 24-hour Holter monitoring.
- Patients were assessed for major or minor depression using standardized criteria.
- Ventricular arrhythmias, specifically VT, were identified via Holter monitoring.
Main Results:
- 20% of CAD patients met criteria for depression.
- Depressed CAD patients had a significantly higher prevalence of VT (23.8%) compared to nondepressed patients (3.7%).
- This association remained significant after adjusting for relevant clinical factors.
Conclusions:
- Depression is linked to a higher incidence of VT in patients with coronary artery disease.
- This increased arrhythmia burden may contribute to the elevated cardiac mortality observed in depressed CAD patients.
- Screening for and treating depression in CAD patients may be crucial for improving outcomes.
Purpose:
The purpose of this study was to examine the relationship between psychiatric depression and ventricular arrhythmias in patients with coronary artery disease (CAD). The hypothesis was that depressed patients with CAD would have a higher prevalence of ventricular tachycardia (VT) than nondepressed patients with CAD.
Patients And Methods:
One hundred three patients who were found to have significant CAD by elective diagnostic cardiac catheterization were administered a standardized psychiatric interview and underwent 24-hour Holter monitoring.
Results:
Twenty-one patients (20%) met the criteria for either major or minor depression. There were no significant differences between depressed and nondepressed patients with CAD in severity of CAD or in ventricular function. Five (23.8%) of the depressed patients and three (3.7%) of the nondepressed patients exhibited episodes of VT during 24 hours of Holter monitoring (p < 0.008). This difference remained significant even after controlling for relevant covariates.
Conclusions:
We conclude that there is a higher prevalence of VT among patients with CAD and depression than among those CAD patients without depression. This may help to explain the increased risk for cardiac mortality in depressed patients with CAD.