Key result
Severe depressive symptoms before angiography increased the risk of major adverse cardiovascular events at 12 months by 2.81 times compared to patients without depressive symptoms.
Why the study?
Depression is closely related to coronary artery disease, but the association of depression before angiography with major adverse cardiovascular events remains unknown.
Does the presence of depressive symptoms increase the risk of major adverse cardiovascular events in patients undergoing first-time angiography?
Cohort (n=410)
No
Does the presence of depressive symptoms increase the risk of major adverse cardiovascular events in patients undergoing first-time angiography?
Depressive symptoms prior to angiography are associated with an approximately twofold increased risk of major adverse cardiovascular events at 1 year, independent of CAD severity.
Supports depression screening pre-angiography; hypothesis-generating for treatment effects on MACE.
BACKGROUND: Depression is closely related to coronary artery disease (CAD). However, the association of depression before angiography with major adverse cardiovascular event (MACE) is still unknown. METHODS: In a prospective cohort study, 410 patients underwent angiography for the first time between 2016 and 2017 in Dr. Heshmat Hospital, Rasht, Iran. Demographic and medical information were collected and depressive symptoms were assessed using Beck Depression Inventory-II (BDI-II). The patients were followed for one year after angiography. Chi-square test and analysis of variance (ANOVA) were performed to compare demographic and clinical characteristics of patients between different levels of depressive symptoms. Multiple Cox regression analysis was performed to assess the association between depression symptoms before angiography and MACE rate controlled for the effect of confounders. RESULTS: Of 410 patients, follow-up data were available for 380 (95%) patients. the MACE occurred in 134 (35%) patients. Depressive symptoms were observed in 42% of patients. Based on multivariable Cox regression analysis, adjusted for CAD severity, the risk of one-year MACE occurrence in patients with mild, moderate, and severe depressive symptoms was 1.96 [95% confidence interval (CI) for hazard ratio (HR): 1.30-2.94], 1.88 (95% CI for HR: 1.15-3.09), and 2.81 (95% CI for HR: 1.56-5.06) times that of patients without depressive symptoms, respectively. Depression in patients before angiography increased the risk of MACE up to 2.045 times. CONCLUSION: The results showed that MACE in patients with depression was more than patients without depression. MACE in different levels of depression (mild, moderate, severe) was not significantly different.
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Dadkhah-Tirani et al. (2020) conducted a cohort in Coronary artery disease (n=410). Severe depressive symptoms vs. No depressive symptoms was evaluated on Major adverse cardiovascular events (MACE) at 1 year (HR 2.81, 95% CI 1.56-5.06, p=0.001). Severe depressive symptoms before angiography increased the risk of major adverse cardiovascular events at 12 months by 2.81 times compared to patients without depressive symptoms.
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