Brief depression screening with the PHQ-2 associated with prognosis following percutaneous coronary intervention with paclitaxel-eluting stenting.
BACKGROUND
Depression is associated with adverse prognosis in cardiac patients, warranting the availability of brief and valid instruments to identify depressed patients in clinical practice.


OBJECTIVE
We examined whether the two-item Patient Health Questionnaire (PHQ-2) was associated with adverse events in percutaneous coronary intervention (PCI) patients treated with paclitaxel-eluting stenting (using the continuous score and various cutoffs), overall and by gender.


METHODS
Prospective follow-up study.


METHODS
Consecutive PCI patients (n = 796) seen at a university medical centre.


METHODS
PHQ-2 at baseline. The study endpoint was an adverse event, defined as a combination of death or non-fatal myocardial infarction (MI) at follow-up (mean of 1.4 years).


RESULTS
At follow-up, 47 patients had experienced an adverse event. Using the continuous score of the PHQ-2 and the recommended cutoff > or =3, depressive symptoms were not associated with adverse events (ps > 0.05). Using a cutoff > or =2, depressive symptoms were significantly associated with adverse events (HR: 1.89; 95% CI: 1.06-3.35) and remained significant in adjusted analysis (HR: 1.90; 95% CI: 1.05-3.44). Depressive symptoms were associated with an increased risk of adverse events in men (HR: 2.69; 95% CI: 1.36-5.32) but not in women (HR: 0.76; 95% CI: 0.24-2.43); these results remained in adjusted analysis.


CONCLUSIONS
Depression screening with a two-item scale and a cutoff score of > or =2 was independently associated with adverse events at follow-up. The PHQ-2 is a brief and valid measure that can easily be used post PCI to identify patients at risk for adverse health outcomes.
Pedersen
Susanne S
SS
CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands. s.s.pedersen@uvt.nl
Denollet
Johan
J
de Jonge
Peter
P
Simsek
Cihan
C
Serruys
Patrick W
PW
van Domburg
Ron T
RT
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012307:Risk Factors
D017239:Paclitaxel