Cardiovascular risk profile before coronary artery bypass graft surgery in relation to depression and anxiety disorders: An age and sex propensity matched study.
OBJECTIVE
The cardiovascular risk profile and postoperative morbidity outcomes of anxiety disorder patients undergoing coronary artery bypass surgery is not known.


METHODS
In a cross-sectional design, 114 consecutive coronary artery bypass graft surgery patients were evaluated to create four matched groups (30 with anxiety disorder, 27 with depression disorder and 57 age-sex matched coronary artery bypass surgery control patients with no depression or anxiety disorder).


RESULTS
By comparison to non-depression disorder age-sex matched controls, depressed patients presented for coronary artery bypass surgery with significantly greater myocardial inflammatory markers (Troponin T>02, 33.3% vs. 11.1%, p=.03), metabolic risk (body surface area>35 (22.2% vs. 0%, p=.03), comorbid cardiovascular risk (peripheral vascular disease 18.5% vs. 0%, p=.05). Depressed patients also recorded longer intraoperative time at higher temperatures >37°C on cardiopulmonary bypass (11.1 ± 9.0 vs. 6.0 ± 4.9, p<005) and had higher maximum postoperative Troponin T (.44 ± .2 vs. .28 ± .1, p=.03). Patients with anxiety disorder on the other hand presented with significantly higher Creatinine Kinase-Muscle Brain (5 IQR 4-5 ng/ml vs. 4 IQR 3-4 ng/ml, p=.04), higher intraoperative glucose levels (7.8 ± 2.5 mmol/l vs. 7.0 ± 1.2 mmol/l, p=.05), and received fewer grafts (2.1 ± .9 vs. 2.5 ± .9 p=.04).


CONCLUSIONS
A differential cardiovascular risk profile and postoperative outcome was observed dependent on anxiety and depression disorder status. There were few modifiable cardiovascular risk factors at the time of surgery other than psychiatric status, perioperative management of depression and anxiety may have promise to reduce further cardiac morbidity after coronary artery bypass surgery.
Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre, South Australia, Australia; Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, Australia. Electronic address: phillip.tully@adelaide.edu.au.
Phillip J
PJ
Tully
Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre, South Australia, Australia.
Richard F
RF
Newland
Cardiac Surgery Research, Department of Surgery, Flinders Medical Centre, South Australia, Australia.
Robert A
RA
Baker
D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology / Q000523:psychology*; D002318:Cardiovascular Diseases / Q000523:psychology* / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D057216:Propensity Score; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors; D013021:South Australia; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology
Anxiety disorders; Cardiopulmonary bypass; Coronary artery bypass; Depressive disorder