Key result
A steeper diurnal cortisol slope measured 60 days after CABG surgery predicted reduced odds of depression at 12 months (OR 0.661; 95% CI 0.437-0.998; p=0.049).
Why the study?
Does diurnal cortisol slope predict depression 12 months after CABG surgery?
Cohort (n=171)
No
Does diurnal cortisol slope predict depression 12 months after CABG surgery?
Odds Ratio: 0.661 (95% CI 0.437–0.998)
p-value: p=0.049
A steeper diurnal cortisol slope 60 days post-CABG is associated with a lower risk of depression at 12 months, suggesting early recovery adaptation may have long-term psychological benefits.
Should not yet change post-CABG depression management; leaves open whether diurnal cortisol slope is a modifiable target.
Alterations in the diurnal profile of cortisol have been associated with depressed mood in patients with coronary heart disease. The relationship between cortisol output and depressed mood has not been investigated prospectively in coronary artery bypass graft (CABG) patients before. We aimed to study the relationship between cortisol measured pre- and post-operatively and depression symptoms measured 12 months after CABG surgery. We analysed data from 171 patients awaiting first-time, elective CABG surgery from the pre-assessment clinic at St. George's Hospital, London. The Beck Depression Inventory (BDI) was used to assess depression symptoms and saliva samples were collected to measure diurnal cortisol. Baseline assessments of depression and cortisol were obtained an average 29days before surgery, short-term follow-up of cortisol occurred 60days after surgery and long-term follow-up of depression was assessed 378days after surgery. Baseline cortisol slope was not associated with depression at 12-month follow-up. However, a steeper cortisol slope measured 60days after surgery predicted reduced odds of depression (BDI≥10) 12 months after surgery (odds ratio 0.661, 95% confidence interval 0.437-0.998, p=0.049) after controlling for covariates. These findings suggest interventions aimed at improving adaptation in the early recovery period may have long-term benefits in this patient group.
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Poole et al. (2016) conducted a cohort in Coronary artery bypass graft (CABG) (n=171). Steeper diurnal cortisol slope 60 days after surgery was evaluated on Depression (BDI≥10) 12 months after surgery (OR 0.661, 95% CI 0.437-0.998, p=0.049). A steeper diurnal cortisol slope measured 60 days after CABG surgery predicted reduced odds of depression at 12 months (OR 0.661; 95% CI 0.437-0.998; p=0.049).