The large-scale data on association of depression in elderly patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) is limited. Our study aims to evaluate the impact of depression on the outcomes of PCI in older hospitalized patients with ACS. ACS hospitalizations among older patients (≥65 years) undergoing PCI were identified using the National Inpatient Sample (2016-2020) and was stratified into 2 groups: with vs. without depression. Logistic regression analysis was performed to calculate odds of in-hospital mortality and complications: PCI related bleeding, intracranial bleed, cardiac arrest, stroke and cardiogenic shock (CS). Chi square test was used analyze baseline sociodemographic and comorbid conditions. Of total 862,855 elderly ACS patients undergoing PCI, 8% had depression (n= 69370). Compared to the depressed group, the nondepressed population more frequently consisted of males (63.4% vs. 46.5%), Blacks (7.7% vs. 4.9%), and less frequently, Whites (81.7% vs. 87.7%). The depressed group had lower odds of ACM (0.82, 95% CI 0.74-0.90, p<0.001) and CS (OR 0.82, CI 0.76-0.88, p<0.001). An increasing trend of Impella insertion and a decreasing trend of IABP insertion and respiratory failure was noted in both groups (p<0.001). An increase in the trend of ACM (0.61% vs. 0.24% increase from 2016 to 2020), CS was noted in the nondepressed group (p<0.001). Our study highlights the paradoxically decreased odds of ACM and CS in elderly ACS patients undergoing PCI. Further studies are warranted to evaluate the cause of this paradox.
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Sawhney et al. (2024) studied this question.
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