Key result
CABG linked to ~5% higher risk of new-onset depression vs matched controls.
Why the study?
Depression in coronary heart disease is associated with worse outcomes, prompting investigation into the long-term risk of new-onset depression after CABG compared to the general population.
Does coronary artery bypass grafting increase the risk of new onset depression in adult patients compared to matched controls from the general population?
Cohort (n=620,789)
Yes
Does coronary artery bypass grafting increase the risk of new onset depression in adult patients compared to matched controls from the general population?
CABG is associated with an increased long-term risk of developing severe depression requiring hospital care, particularly in younger patients during the first 5 years post-surgery.
CABG was associated with marginally higher depression risk in younger patients; leaves open whether this reflects causation or confounding and requires prospective validation.
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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Stenman et al. (2022) conducted a cohort in Coronary artery disease requiring coronary artery bypass grafting (n=620,789). Coronary artery bypass grafting (CABG) vs. Age- and sex-matched controls from the general population was evaluated on New onset of depression (aHR 1.05, 95% CI 1.01-1.09, p=0.0091). Coronary artery bypass grafting was associated with a marginally increased adjusted risk of new onset depression compared to matched controls (aHR 1.05, p=0.0091), which was especially pronounced in patients <65 years during the first 5 years.
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