Prognostic Significance Of Depression For Patients Undergoing Percutaneous Coronary Intervention

Backgrounds Depression as a common comorbidity of coronary heart disease (CHD), has been confirmed to be an independent predictor of major adverse cardiovascular events (MACE) for patients with acute coronary syndrome (ACS) and patients undergoing coronary artery bypass grafting (CABG). Percutanous coronaty intervention (PCI) is the widely used treatment for CHD. However, the study about the prevalence and prognostic significance of depression following PCI is limited.Objectives To investigate the impact of depression on clinical outcomes for patients with coronary artery disease undergoing PCI.Methods Four hundred patients treated with PCI were assessed by Hospital Anxiety and Depression Scale(HAD) one day before and two weeks after the procedure. Patients who have a score≥8 were assessed by The Mini-International Neuropsychiatric Interview (M.I.N.I.). Patients were divided into two groups according to the evaluation of two weeks after procedure. All the patients were followed for 12 months after coronary stenting for the occurrence of major adverse cardiovascular events (MACE), including all-cause mortality, nonfatal myocardial infarction or target lesion revascularization.Results Depression was present in 38.5% (n=154) of patients after procedure, which was significantly higher than that before procedure (25.5%, p<0.001). Among patients with post-procedure depression, the MACE rate was 20.1% during the 12 months of follow-up, which was significantly higher than that among patients without depression (7.7%, p＜0.001). After adjustment for other factors that affect cardiovascular outcome, post-procedure depression was an independent predictor of 12-month MACE (HR 2.34,95% CI 1.26-4.03, p=0.024)Conclusion Patients treated with PCI had a high prevalence of depression, and post-procedure depression is an independent predictor of 12-month MACE.