Impact of depression on prognosis of patients with coronary heart disease undergoing revascularization
10.3760/cma.j.issn.0253-3758.2012.02.005
- VernacularTitle:抑郁对冠心病行再血管化治疗患者预后的影响
- Author:
Xi-Ming LI
1
;
Ting-Ting LI
;
Hong-Liang CONG
;
Zhi-Gang GUO
;
Jing-Hua SONG
;
Ru ZHAO
;
Jian-Yong XIAO
Author Information
1. 天津胸科医院
- Keywords:
Coronary disease;
Depression;
Myocardial revascularization;
Prognosis
- From:
Chinese Journal of Cardiology
2012;40(2):99-103
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of depression on clinical outcome of patients undergoing revascularization.Methods Self-rating depression scale (SDS) assessment was made before and after coronary artery bypass grafting (CABG,n =345 ) and percutaneous coronary intervention( PCI,n =308 )procedure.Patients were divided into depression and non-depression group.All patients were followed up for 12 months after procedure for the occurrence of rehospitalization and major adverse cardiovascular events (MACE) including all-cause mortality,nonfatal myocardial infarction or target lesion revascularization.Results Depression was present in 40.9％ ( n =141 ) of patients after CABG,which was significantly higher than before procedure (24.3％,P ＜ 0.01 ).The MACE rate was significantly higher in patients with post-procedure depression[ 8.5％ ( 12/141 ) ] than in patients without depression [ 2.9％ (6/204),P ＜0.05 ] and the incidences of target lesion revascularization and rehospitalization were also significantly higher in depression patients than in non-depression patients during the 12 months follow-up ( all P ＜ 0.05 ).Depression was present in 36.4％ (n =112) of patients after PCI,which was significantly higher than that before procedure (28.6％,P ＜0.05).The MACE rate [8.0％ (9/112) vs.2.0％ (4/196)]and rehospitalization rate [ 12.5％ ( 14/112 ) vs.4.6％ ( 9/196 ) ] were significantly higher in depression patients than in patients without depression during the 12 months follow-up ( P ＜ 0.05 ).There was no significant difference on SDS score between the PCI and CABG before the procedure.However,after the procedure,the SDS score for patients undergoing CABG was significantly higher than in patients undergoing PCI (48.9 ± 9.8 vs.45.7 ± 10.5 P =0.01 ).The level of serum IL-6 was significantly higher in depression patients than in patients without depression ( P ＜ 0.05 ).Conclusion Prevalence of depression is high in patients treated with revascularization procedures and is linked with poor post-procedure prognosis.
