title: Depression is independently associated with 7-year mortality in patients treated with percutaneous coronary intervention: results from the RESEARCH registry.
abstract: BACKGROUND
  Depression has been associated with poor prognosis in patients with coronary artery disease (CAD), but little is known about the impact of depression on long-term mortality. We examined whether depression was associated with 7-year mortality in patients treated with percutaneous coronary intervention (PCI), after adjusting for socio-demographic and clinical characteristics, anxiety, and the distressed (Type D) personality.
  
  
  METHODS
  The sample comprised a cohort of consecutive PCI patients (N=1234; 72.0% men; mean age 62.0 ± 11.1 years, range [26-90] years) from the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry. At baseline (i.e., 6 months post-PCI), patients completed the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression and the Type D scale (DS14) to assess Type D personality. The endpoint was defined as all-cause mortality.
  
  
  RESULTS
  The prevalence of depression (HADS-D ≥ 8) was 26.2% (324/1236). After a median follow-up of 7.0 ± 1.6 years, 187 deaths (15.2%) from any cause were recorded. The incidence of all-cause mortality in depressed patients was 23.5% (76/324) versus 12.2% (111/910) in non-depressed patients. Cumulative hazard functions differed significantly for depressed versus non-depressed patients (log-rank X(2)=25.57, p<.001). In multivariable analysis, depression remained independently associated with all-cause mortality (HR=1.63; 95% CI [1.05-2.71], p=.038), after adjusting for socio-demographic and clinical characteristics, anxiety, and Type D personality.
  
  
  CONCLUSIONS
  Depression was independently associated with a 1.6-fold increased risk for 7-year mortality, above and beyond anxiety and Type D personality. Future studies are warranted to further elucidate the potential pathways linking depression to long-term mortality following PCI.
authors.affiliation: Center of Research on Psychology in Somatic diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Nikki L
authors.initials: NL
authors.lastname: Damen
authors.forename: Henneke
authors.initials: H
authors.lastname: Versteeg
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Robert-Jan M
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000401:mortality* / Q000523:psychology / Q000601:surgery*; D003863:Depression / Q000401:mortality* / Q000523:psychology; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000401:mortality* / Q000523:psychology; D012042:Registries; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage*; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D020123:Sirolimus