Depressive disorder in patients with coronary artery disease was associated with a lower five-year survival rate (77.8% vs 94.1%) and increased cardiovascular mortality (22.2% vs 5.9%, p=0.03).
Cohort (n=79)
Does depressive disorder worsen clinical presentation and reduce five-year survival in patients with chronic CAD and prior myocardial infarction?
Depressive disorder in patients with chronic CAD and prior myocardial infarction is associated with more frequent angina, lower exercise tolerance, and significantly reduced five-year survival.
Absolute Event Rate: 77.8% vs 94.1%
p-value: p=0.04
Aim. To assess the effect of depressive disorder (DD) on the clinical presentation of coronary artery disease (CAD) and five-year survival rate of patients with chronic CAD. Materials and methods. The study included 79 patients with functional class II–III exertional angina who experienced myocardial infarction more than 6 months before. The patients were divided into two groups: group 1 (n = 45) consisted of patients with CAD and depression and group 2 (n = 34) encompassed patients with CAD without depression. The clinical presentation of CAD was assessed by the results of filling out the angina pectoris self-control diary and exertion tests. The presence and severity of DD were determined using psychometric scales, such as Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory (BDI), and verified by the psychiatrist. Information about five-year survival was obtained via telephone interviews with the patients and their relatives. Results . Patients with CAD and DD were characterized by more frequent episodes of angina pectoris during a week (10 8; 14 vs 6 4; 7, p = 0.000004), an increased demand for nitroglycerin (4 0; 10 tablets vs 0 0; 4 tablets, p = 0.001), and lower exercise tolerance (50 25; 75 W vs 75 50; 75 W (p = 0.06), 350 250; 400 meters vs 435 350; 500 meters (p = 0.01) than CAD patients without DD. The five-year survival rate was significantly lower in group 1 than in group 2 (69 62; 72 vs 71 68; 72 months (p = 0.04)), 35 (77.8%) vs 32 (94.1%) patients survived. In group 1, a greater number of deaths from cardiovascular accidents (10 (22.2%) vs 2 (5.9%)) was noted (log-rank test, p = 0.03). Conclusion . In patients with CAD, associated depression results in aggravation of the clinical course of CAD and poor disease prognosis, which requires timely diagnosis and treatment of DD.
Нонка et al. (Fri,) conducted a cohort in Coronary artery disease and depressive disorder (n=79). Depressive disorder vs. No depressive disorder was evaluated on Five-year survival rate (p=0.04). Depressive disorder in patients with coronary artery disease was associated with a lower five-year survival rate (77.8% vs 94.1%) and increased cardiovascular mortality (22.2% vs 5.9%, p=0.03).