Abstract
Background
Since the early 2000s the treatment of choice for an acute myocardial infarction has
moved from thrombolytic therapy to primary PCI (pPCI). As a result, the majority of
patients undergoing PCI shifted from stable angina pectoris (SA) to acute coronary
syndrome (ACS). Additionally the previously observed association between depression
and anxiety and long-term outcome in patients who underwent a PCI may have been changed.
The main objective of this study was to investigate the predictive value of depression
and anxiety for 10-year mortality, in a cohort with post-PCI patients treated for
SA versus patients treated for ACS.
Methods
This prospective single center cohort consists of a consecutive series of patients
(n = 528) treated with PCI. At 1 month post-PCI, patients completed the Dutch version of the Hospital Anxiety and Depression
Scale (HADS).
Results
After adjustment for baseline characteristics depression was associated with higher
10-year mortality post-PCI (HR 1.58 95% Confidence Interval [95% CI] 1.04–2.40). In
the ACS population no association between depression and 10-year mortality was found
(HR 1.05 95% CI 0.62–1.79), in contrast to the SA population (HR 1.97 95% CI 1.09–3.57).
After additional adjustment for anxiety, depression was no longer associated with
higher mortality.
Conclusions
Anxiety at baseline was associated with an increased 10-year mortality rate after
PCI. Depression was also associated with higher 10-year mortality, however the association
disappeared after additional adjustment for anxiety. This finding was more pronounced
in patients presenting with SA as compared to those presenting with ACS, which might
be a result of the increasing number of ACS patients treated with pPCI.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to International Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (committee on management of patients with chronic stable angina).J. Am. Coll. Cardiol. 1999; 33: 2092-2197
- ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction; a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (committee to revise the 1999 guidelines for the management of patients with acute myocardial infarction).J. Am. Coll. Cardiol. 2004; 44: E1-E211
- Changes in clinical profile, treatment, and mortality in patients hospitalised for acute myocardial infarction between 1985 and 2008.PLoS One. 2011; 6e26917
- Prevalence of depression in survivors of acute myocardial infarction.J. Gen. Intern. Med. 2006; 21: 30-38
- Effect of depression on late (8 years) mortality after myocardial infarction.Am. J. Cardiol. 2008; 101: 602-606
- Depression is independently associated with 7-year mortality in patients treated with percutaneous coronary intervention: results from the RESEARCH registry.Int. J. Cardiol. 2013; 167: 2496-2501
- Depression and anxiety symptoms as predictors of mortality in PCI patients at 10 years of follow-up.Eur. J. Prev. Cardiol. 2016; 23: 552-558
- Depression, not anxiety, is independently associated with 5-year hospitalizations and mortality in patients with ischemic heart disease.J. Psychosom. Res. 2013; 75: 518-525
- Transient impact of baseline depression on mortality in patients with stable coronary heart disease during long-term follow-up.Clin. Res. Cardiol. 2014; 103: 389-395
- Anxiety is associated with a reduction in both mortality and major adverse cardiovascular events five years after coronary stenting.Eur. J. Prev. Cardiol. 2015; 22: 75-82
- Can anxiety and depression, separately or in combination predict subjective health status 10 years post-PCI?.Int. J. Cardiol. 2015; 186: 57-59
- Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association.Circulation. 2014; 129: 1350-1369
- Comparison of long-term mortality after percutaneous coronary intervention in patients treated for acute ST-elevation myocardial infarction versus those with unstable and stable angina pectoris.Am. J. Cardiol. 2009; 104: 333-337
- Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina.Circulation. 2002; 105: 2367-2372
- The distressed (Type D) personality mediates the relationship between remembered parenting and psychological distress in cardiac patients.Psychol. Health. 2014; 29: 318-333
- The Declaration of Helsinki.BMJ. 2007; 335: 624-625
- The validity of the Hospital Anxiety and Depression Scale. An updated literature review.J. Psychosom. Res. 2002; 52: 69-77
- A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects.Psychol. Med. 1997; 27: 363-370
- The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R).JAMA. 2003; 289: 3095-3105
- Anxiety disorders in women.Psychiatr. Clin. North Am. 2003; 26 (vi-vii): 621-672
- Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US National Comorbidity Survey.Br. J. Psychiatry Suppl. 1996; : 17-30
- Population trends in percutaneous coronary intervention: 20-year results from the SCAAR (Swedish Coronary Angiography and Angioplasty Registry).J. Am. Coll. Cardiol. 2013; 61: 1222-1230
- Depression and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association.Circulation. 2008; 118: 1768-1775
- Early invasive versus conservative strategies for unstable angina and non-ST elevation myocardial infarction in the stent era.Cochrane Database Syst. Rev. 2010; CD004815
- Coronary revascularization trends in the United States, 2001–2008.JAMA. 2011; 305: 1769-1776
- Indication for percutaneous coronary intervention is not associated with symptoms of anxiety and depression.Int. J. Cardiol. 2013; 168: 4897-4898
- Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians' diagnoses.J. Affect. Disord. 2004; 78: 131-140
- Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence.Arch. Intern. Med. 2000; 160: 2101-2107
- History of depression and survival after acute myocardial infarction.Psychosom. Med. 2009; 71: 253-259
- Only incident depressive episodes after myocardial infarction are associated with new cardiovascular events.J. Am. Coll. Cardiol. 2006; 48: 2204-2208
- Evidence-based treatment of emotional distress in patients with ischemic coronary heart disease.Psychiatr. Ann. 2016; : 677-682
- Long-term safety of drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis.J. Am. Coll. Cardiol. 2015; 65: 2496-2507
- Short- and long-term outcomes with drug-eluting and bare-metal coronary stents: a mixed-treatment comparison analysis of 117,762 patient-years of follow-up from randomized trials.Circulation. 2012; 125: 2873-2891
Article info
Publication history
Published online: October 06, 2017
Accepted:
October 2,
2017
Received in revised form:
September 5,
2017
Received:
March 7,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
