Key result
Postprocedure depression linked to a ~151% increase in 3-year MACE after PCI.
Why the study?
The impact of depression on clinical outcomes after PCI in patients with coronary artery disease was not well established.
Does post-procedure depression increase the risk of major adverse cardiovascular events in patients undergoing percutaneous coronary intervention?
Cohort (n=400)
Does post-procedure depression increase the risk of major adverse cardiovascular events in patients undergoing percutaneous coronary intervention?
Hazard Ratio: 2.51 (95% CI 1.57–4.02)
Absolute Event Rate: 27.3% vs 13%
p-value: p=<0.001
Post-procedure depression is common and independently predicts a 2.5-fold increased risk of 3-year MACE in patients undergoing PCI.
May support post-PCI depression screening; leaves open whether treatment reduces MACE.
OBJECTIVE: The aim of this study was to investigate the impact of depression on the clinical outcomes of patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). METHODS: A total of 400 patients treated with PCI were assessed using the Mini-International Neuropsychiatric Interview 1 day before and 2 weeks after the procedure. All patients were followed up for 3 years after the procedure. The primary endpoint was a major adverse cardiovascular event (MACE) including mortality, nonfatal myocardial infarction, or repeat revascularization. RESULTS: Depression was present in 38.5% (n=154) of patients after the procedure, which was significantly higher than that before the procedure (25.5%, P<0.001). Patients with postprocedure depression had a higher rate of MACE (27.3 vs. 13.0%, P<0.001), mortality (5.8 vs. 2.0%, P=0.044), and repeat revascularization (13.0 vs. 6.5%, P=0.027) compared with patients without depression during the 3 years of follow-up. After adjustment for other factors that affect cardiovascular outcomes, postprocedure depression was seen to be an independent predictor of 3-year MACE [hazard ratio: 2.51, 95% confidence interval (CI): 1.57-4.02, P<0.001], mortality (3.60, 95% CI: 1.16-11.22, P=0.027), and repeat revascularization (hazard ratio: 2.22, 95% CI: 1.09-4.51, P=0.029). CONCLUSION: Depression is common among patients treated with PCI. Postprocedure depression is an independent predictor of 3-year MACE, mortality, and repeat revascularization.
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Wang et al. (2013) conducted a cohort in Coronary artery disease undergoing percutaneous coronary intervention (n=400). Postprocedure depression vs. No postprocedure depression was evaluated on Major adverse cardiovascular event (MACE) including mortality, nonfatal myocardial infarction, or repeat revascularization (HR 2.51, 95% CI 1.57-4.02, p=<0.001). Postprocedure depression was associated with a significantly higher rate of 3-year MACE compared with no depression (27.3% vs. 13.0%; HR 2.51, 95% CI 1.57-4.02, P<0.001).
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