Association of depression with adverse cardiovascular events after percutaneous coronary intervention.
OBJECTIVE
The aim of this study was to investigate the impact of depression on the clinical outcomes of patients with coronary artery disease undergoing percutaneous coronary intervention (PCI).


METHODS
A total of 400 patients treated with PCI were assessed using the Mini-International Neuropsychiatric Interview 1 day before and 2 weeks after the procedure. All patients were followed up for 3 years after the procedure. The primary endpoint was a major adverse cardiovascular event (MACE) including mortality, nonfatal myocardial infarction, or repeat revascularization.


RESULTS
Depression was present in 38.5% (n=154) of patients after the procedure, which was significantly higher than that before the procedure (25.5%, P<0.001). Patients with postprocedure depression had a higher rate of MACE (27.3 vs. 13.0%, P<0.001), mortality (5.8 vs. 2.0%, P=0.044), and repeat revascularization (13.0 vs. 6.5%, P=0.027) compared with patients without depression during the 3 years of follow-up. After adjustment for other factors that affect cardiovascular outcomes, postprocedure depression was seen to be an independent predictor of 3-year MACE [hazard ratio: 2.51, 95% confidence interval (CI): 1.57-4.02, P<0.001], mortality (3.60, 95% CI: 1.16-11.22, P=0.027), and repeat revascularization (hazard ratio: 2.22, 95% CI: 1.09-4.51, P=0.029).


CONCLUSIONS
Depression is common among patients treated with PCI. Postprocedure depression is an independent predictor of 3-year MACE, mortality, and repeat revascularization.
aDepartment of Cardiology, Beijing Anzhen Hospital, Capital Medical University bDepartment of Clinical Psychopharmacology, Institute of Mental Health, Peking University cThe Key Laboratory for Mental Health, Ministry of Health dZhongguancun Hospital, Beijing eAffiliated Hospital of Jilin Medical College, Jilin, China.
Zhi Jian
ZJ
Wang
Min
M
Guo
Tian Mei
TM
Si
Ming Ming
MM
Jiang
Si Meng
SM
Liu
Yu Yang
YY
Liu
Ying Xin
YX
Zhao
Dong Mei
DM
Shi
Yu Jie
YJ
Zhou
D002681:China / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome