Key result
Pre-existing depression was not associated with all-cause mortality in patients undergoing PCI for angina (HR 1.013) or AMI (HR 0.991), although younger angina patients had a higher mortality risk.
Why the study?
The impact of pre-existing depression on mortality in patients with established CAD remains unclear.
Does pre-existing depression increase all-cause mortality in patients with established CAD undergoing PCI?
Cohort (n=90,305)
Yes
Does pre-existing depression increase all-cause mortality in patients with established CAD undergoing PCI?
Hazard Ratio: 1.013 (95% CI 0.893–1.151)
p-value: p=0.836
Pre-existing depression does not worsen overall mortality in patients undergoing PCI for CAD, but it significantly increases mortality risk in younger patients (<65 years) presenting with angina.
Pre-existing depression should not yet alter post-PCI risk assessment; leaves open age-specific mortality links in younger angina patients.
The impact of pre-existing depression on mortality in individuals with established coronary artery disease (CAD) remains unclear. We evaluate the clinical implications of pre-existing depression in patients who underwent percutaneous coronary intervention (PCI). Based on National Health Insurance claims data in Korea, patients without a known history of CAD who underwent PCI between 2013 and 2017 were enrolled. The study population was divided into patients with angina (n=50,256) or acute myocardial infarction (AMI; n=40,049). The primary endpoint, defined as all-cause death, was compared between the non-depression and depression groups using propensity score matching analysis. After propensity score matching, there were 4,262 and 2,346 matched pairs of patients with angina and AMI, respectively. During the follow-up period, there was no significant difference in the incidence of all-cause death in the angina (hazard ratio [HR] of depression, 1.013; 95% confidence interval [CI]: 0.893-1.151) and AMI (HR, 0.991; 95% CI: 0.865-1.136) groups. However, angina patients less than 65 years of age with depression had higher all-cause mortality (HR, 1.769; 95% CI: 1.240-2.525). In Korean patients undergoing PCI, pre-existing depression is not associated with poorer clinical outcomes. However, in younger patients with angina, depression is associated with higher all-cause mortality.
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Park et al. (2020) conducted a cohort in Coronary artery disease undergoing percutaneous coronary intervention (n=90,305). Pre-existing depression vs. No pre-existing depression was evaluated on All-cause death (angina cohort) (HR 1.013, 95% CI 0.893-1.151, p=0.836). Pre-existing depression was not associated with all-cause mortality in patients undergoing PCI for angina (HR 1.013) or AMI (HR 0.991), although younger angina patients had a higher mortality risk.
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