After seven years of follow up, depressed patients were 1.5 times more likely to have died than non-depressed patients. The findings were independent of age, gender, clinical characteristics, anxiety and the distressed (Type D) personality.
The research was presented at the 12th Annual Spring Meeting on Cardiovascular Nursing, 16-17 March, in Copenhagen, Denmark.
Depression has been associated with poor outcomes in coronary artery disease but previous studies have mainly looked at short term effects, primarily in patients who have had a myocardial infarction or a coronary bypass operation. The current study (FPN 17) investigated the impact of depression on mortality during a 7-year follow up period in patients treated with percutaneous coronary intervention (PCI).
For the study, 1,234 PCI patients aged 26-90 years (average age 62) from the Rapamycin- Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry completed the Hospital Anxiety and Depression Scale (HADS) to assess depression 6 months after having a stent implanted. The endpoint was all-cause mortality.
The prevalence of depression was 26.3% (324 out of 1234 patients). After 7 years there were 187 deaths in total (15.2%). The incidence of all-cause mortality in depressed patients was 23.5% (76 out of 324 patients) versus 12.2% (111 out of 910 patients) in non-depressed patients.
Depression was independently associated with all-cause mortality (hazard ratio=1.56; 95% confidence interval [1.03.35], p = .035) after adjusting for sociodemographics (age, gender), clinical characteristics, anxiety and the Type D personality. Clinical characteristics included type of stent (drug eluting/bare metal), number of vessels obstructed, body mass index, past cardiac surgery or myocardial infarction, indication for the PCI procedure, coronary risk factors (hypertension, hypercholesterolemia, diabetes, family history of cardiovascular disease, smoking) and cardiac medications (aspirin, ACE inhibitors, beta blockers, calcium antagonists, diuretics, nitrates and statins).
Male gender, older age, and diabetes mellitus were also significantly associated with an increased risk of death after 7 years of follow up, whereas statins were associated with a reduced risk. Anxiety and Type D personality had no significant effect on all-cause mortality.
"The main finding is that patients who are depressed after coronary stenting have a worse prognosis," says lead author Nikki Damen, a PhD student at Tilburg University in the Netherlands. "They die earlier than non-depressed patients."
The reasons for the finding are under investigation. One possible explanation is that depressed patients may have less healthy lifestyles with regard to smoking, drinking alcohol, physical activity, and diet, and may be less likely to take their medications. Another possible explanation is that depression could alter the activity of the sympathetic nervous system, leading to increases in heart rate and blood pressure.
"Doctors and nurses have traditionally focussed on medical factors like diabetes or family history of cardiovascular disease when assessing PCI patients' risk of death, but that's not the whole picture," says Ms Damen. "Psychological factors do matter as well, in combination with the medical factors."
She adds: "More research is needed to determine how to screen for depression in cardiovascular patients, and then how to provide treatment."Authors: ESC Press Office
About the Council on Cardiovascular Nursing and Allied Professions (CCNAP)
The CCNAP aims to promote excellence in Cardiovascular Nursing and Allied Professions through practice education and research. In addition to nurses, allied health professionals belonging to the CCNAP include physiotherapists, dieticians, psychologists, cath lab technicians, imaging and diagnostic technicians and therapists working in rehabilitation and prevention. The CCNAP is one of five Councils of the European Society of Cardiology.
About the European Society of Cardiology (ESC)
The European Society of Cardiology (ESC) represents 75,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.References
ESC Press Office | EurekAlert!
3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg
Better equipped in the fight against lung cancer
16.05.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg
At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.
At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...
There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?
At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...
So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics
Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...
The historic first detection of gravitational waves from colliding black holes far outside our galaxy opened a new window to understanding the universe. A...
A team led by Austrian experimental physicist Rainer Blatt has succeeded in characterizing the quantum entanglement of two spatially separated atoms by observing their light emission. This fundamental demonstration could lead to the development of highly sensitive optical gradiometers for the precise measurement of the gravitational field or the earth's magnetic field.
The age of quantum technology has long been heralded. Decades of research into the quantum world have led to the development of methods that make it possible...
02.05.2018 | Event News
13.04.2018 | Event News
12.04.2018 | Event News
22.05.2018 | Life Sciences
22.05.2018 | Earth Sciences
22.05.2018 | Trade Fair News