Type D personality and diabetes predict the onset of depressive symptoms in patients after percutaneous coronary intervention.
BACKGROUND
Depression is common in cardiac patients and has been associated with adverse clinical outcome. However, little is known about predictors of the onset of depressive symptoms. We examined predictors of the onset of depressive symptoms at 12 months post-percutaneous coronary intervention (PCI) in patients treated in the drug-eluting stent era.


METHODS
Unselected patients, free from depressive symptoms at 6 months with a depression score at 12 months treated with PCI with either drug-eluting or bare stent implantation as part of the RESEARCH registry qualified for inclusion in the current study. Patients completed the Hospital Anxiety and Depression Scale at 6 and 12 months and the Type D Personality Scale (DS14) at 6 months post-PCI. Six months was used as the baseline assessment.


RESULTS
Of 542 patients, 41 (8%) had developed significant depressive symptoms at 12 months. The occurrence of a new cardiac event between 6 and 12 months post-index event did not influence the incidence of depressive symptoms at 12 months. Depressive patients were more likely to have a type D personality (34% vs 16%, P = .003) and diabetes (24% vs 11%, P = .01) than nondepressive patients. Type D personality (odds ratio 3.04, 95% CI 1.50-6.16) and diabetes (odds ratio 2.75, 95% CI 1.25-6.05) were independent predictors of the onset of depressive symptoms 12 months post-PCI in adjusted analyses. In patients with neither risk factors (type D or diabetes), the incidence of depression was 5.1% with the incidence more than doubling to 13.2% and 30% for each additional risk factor.


CONCLUSIONS
Type D personality and diabetes comprise risk factors for the onset of depressive symptoms post-PCI. In clinical practice, patients with these risk factors should be identified and considered for psychosocial intervention targeting depression to enhance secondary prevention.
Pedersen
Susanne S
SS
Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. s.s.pedersen@uvt.nl
Ong
Andrew T L
AT
Sonnenschein
Karel
K
Serruys
Patrick W
PW
Erdman
Ruud A M
RA
van Domburg
Ron T
RT
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D003920:Diabetes Mellitus / Q000523:psychology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010551:Personality; D010552:Personality Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors