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!
Purdue cancer identity technology makes it easier to find a tumor's 'address'
16.11.2018 | Purdue University
Microgel powder fights infection and helps wounds heal
14.11.2018 | Michigan Technological University
Researchers at the University of New Hampshire have captured a difficult-to-view singular event involving "magnetic reconnection"--the process by which sparse particles and energy around Earth collide producing a quick but mighty explosion--in the Earth's magnetotail, the magnetic environment that trails behind the planet.
Magnetic reconnection has remained a bit of a mystery to scientists. They know it exists and have documented the effects that the energy explosions can...
Biochips have been developed at TU Wien (Vienna), on which tissue can be produced and examined. This allows supplying the tissue with different substances in a very controlled way.
Cultivating human cells in the Petri dish is not a big challenge today. Producing artificial tissue, however, permeated by fine blood vessels, is a much more...
Faster and secure data communication: This is the goal of a new joint project involving physicists from the University of Würzburg. The German Federal Ministry of Education and Research funds the project with 14.8 million euro.
In our digital world data security and secure communication are becoming more and more important. Quantum communication is a promising approach to achieve...
On Saturday, 10 November 2018, the research icebreaker Polarstern will leave its homeport of Bremerhaven, bound for Cape Town, South Africa.
When choosing materials to make something, trade-offs need to be made between a host of properties, such as thickness, stiffness and weight. Depending on the application in question, finding just the right balance is the difference between success and failure
Now, a team of Penn Engineers has demonstrated a new material they call "nanocardboard," an ultrathin equivalent of corrugated paper cardboard. A square...
09.11.2018 | Event News
06.11.2018 | Event News
23.10.2018 | Event News
19.11.2018 | Science Education
19.11.2018 | Ecology, The Environment and Conservation
19.11.2018 | Life Sciences