Depression after coronary artery bypass graft (CABG) surgery is common and associated with worse outcomes. The Neuropsychiatric Outcomes After Heart Surgery (NOAHS) study evaluates the vascular depression hypothesis, which implicates cerebrovascular disease as a contributor to late-life depression, as applied to a CABG surgery cohort. We evaluate whether right or left middle cerebral artery (MCA) stenosis or its severity is associated with a greater risk of post-CABG depression. NOAHS was a prospective study of non-demented patients 40 years of age or older having CABG surgery. Depression was evaluated at baseline and monthly after surgery to 12 months. Transcranial Doppler (TCD) assessed intracranial atherosclerosis at baseline. We examined whether MCA stenosis predicted new-onset depression, adjusting for baseline characteristics. In our sample (n = 148, average age 66.1, 75.7 % male), 11 % had baseline depression and 26 % had mild cognitive impairment (MCI). Perceived psychosocial support was high, with a mean score of 82.7 of 100 on the Medical Outcomes Study social support survey. Excluding those with baseline depression, 13 (16 %) developed new-onset depression. New-onset depression was associated with younger age, greater baseline functional impairment, lower perceived psychosocial support, MCI status, and prior depression. MCA stenosis and its severity was not associated with new-onset depression in any model; however, lower perceived psychosocial support did predict new-onset depression. We did not find an association between baseline MCA stenosis and new-onset depression after CABG. Instead, well established risk factors including lower perceived social support were more strongly associated with post-CABG depression.
Oldham et al. (Fri,) studied this question.
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