Depression increases death risk in coronary stent patients

March 16, 2012, European Society of Cardiology

Copenhagen, 16 March 2012: Depression increases the risk of death in patients who have a coronary stent implanted. 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 but previous studies have mainly looked at short term effects, primarily in patients who have had a myocardial infarction or a coronary . The current study (FPN 17) investigated the impact of depression on mortality during a 7-year follow up period in patients treated with percutaneous (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 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 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 [1.03𔃀.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 , 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."

Explore further: Combo of diabetes, depression increases post-MI mortality

Related Stories

Combo of diabetes, depression increases post-MI mortality

February 27, 2012
(HealthDay) -- Having both diabetes and depression significantly increases the risk of dying in the years following a heart attack, beyond the increased risk from either condition alone, according to a study published in ...

Statins linked with lower depression risk in heart patients

February 24, 2012
Patients with heart disease who took cholesterol-lowering statins were significantly less likely to develop depression than those who did not, in a study by Mary Whooley, MD, a physician at the San Francisco VA Medical Center ...

Positive results for unprotected left main coronary artery PCI with drug-eluting stents

June 22, 2011
Patients with normal left ventricular function who undergo elective unprotected left main coronary artery (ULMCA) percutaneous coronary intervention (PCI) with drug-eluting stents (DES) had favorable outcomes according to ...

Study examines multivessel mortality rates

December 29, 2011
(Medical Xpress) -- A new study led by University at Albany School of Public Health Distinguished Professor Emeritus Edward L. Hannan finds a link between higher mortality rates and incomplete revascularization procedures ...

CABG still preferred over PCI in patients with triple vessel disease

August 29, 2011
Results from CREDO-Kyoto PCI/CABG Registry Cohort-2 show that percutaneous coronary intervention (PCI) was associated with significantly higher risk for serious adverse events in patients with triple vessel disease than coronary ...

Recommended for you

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

Place of residence linked to heart failure risk

January 9, 2018
Location. Location. Location.

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

Anne7600
not rated yet Mar 30, 2012
I think stress and depression are under-treated in hospitals. Many clinics and hospitals have gotten great results by offering patients guided meditation solutions. Guided meditation can help reduce complications and reduce stress, which helps patients heal faster. Belleruth Naparstek has more information about the research on her website healthjourneys.com.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.