Depression and Risk of Adverse Cardiovascular Events in Patients with Stable Coronary Artery Disease

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Published: Feb 20, 2014
DOI: https://doi.org/10.31524/bkkmedj.2014.02.003
Keywords:
depression, stable coronary artery disease, major cardiovascular events

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Kitigon Vichairuangthum, MD
Pholphat Losatiankij, MD
Paiboon Chotenopratpat, MD

Abstract

OBJECTIVE: Depression is known to be associated with at least doubling the risk of cardiac events over 1 to 2 years after an acute myocardial infarction (MI). However, less is known about the prevalence and prognosis of depression in outpatient samples especially in short-term follow-up studies in stable coronary artery disease (CAD) patients. The purpose of this study was to evaluate the relationship between depressive disorders and short term risk of major adverse cardiovascular events (MACEs) in stable coronary artery disease patients.


MATERIAL AND METHODS: This prospective study included 134 stable CAD patients at the cardiovascular out patient depart- ment (OPD) clinic at Bangkok Metropolitan Administration (BMA) Medical College and Vajira Hospital. The Thai equivalent of the Montgomery-Asberg Depression Rating Scale (MADRS) score was used. After 6 months, all patients were assessed for major adverse cardiovascular events (MACEs).


RESULTS: 15% of the sample had a depressive condition (MADRS score > 10), yet  less than half of them (20%)  had been treated  with anxiolytic medications. After the 6 months follow-up period, there were no cases reported of cardiac death in either group. Myocardial infarction was seen in the normal MADRS group [Four cases (3.5%)] but none appeared in the group diagnosed with depressive conditions. Two cases (10%) of those with depressive conditions and seven cases (6.10%) of the normal MADRS group had percutaneous  transluminal  coronary  angioplasty  (PTCA); p = 0.525. CABG or stroke was not found in either group. There was no statistically significant different incidences of MACEs (cardiac death, MI, PTCA, CABG, stroke) in either group (10% vs. 9.6%; p = 0.961).


CONCLUSION: There was no statistically significant difference in the short term MACEs between the two groups (those with and without depressive conditions) in this study.

Article Details

How to Cite
1.
Vichairuangthum K, Losatiankij P, Chotenopratpat P. Depression and Risk of Adverse Cardiovascular Events in Patients with Stable Coronary Artery Disease. BKK Med J [Internet]. 2014 Feb. 20 [cited 2024 Nov. 23];7(1):11. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/218725
Issue
Vol. 7 (2014): February
Section
Original Article

This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

References

1. Rudisch B, Nemeroff CB. Epidemiology of comorbid coronary artery disease and depression. Biol Psychaiatry 2003;54:227-40.
2. Sher Y, Lolak S, Maldonado JR. The Impact of Depression in Heart Disease. Curr Psychiatry Rep 2010;12:255-64.
3. Thombs BD, Bass EB, Ford DE, et al. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med 2006;21:30-8.
4. Carney RM, Blumenthal JA, Stein PK, et al. Depression, heart rate variability, and acute myocardial infarction. Circulation 2001;104:2024-8.
5. Pollock BG, Laghrissi-Thode F, Wagner WR. Evaluation of platelet activation in depressed patients with ischemic heart diseas after paroxetine or nortriptyline treatment. J Clin Psychopharmacol 2000;20:137-40.
6. Serebruany VL, Glassman AH, Malinin AI, et al. Enhanced platelet/endothelial activation in depressed patients with acute coronary syndromes:evidence for recent clinical trials. Blood Coagul Fibrinolysis 2003;14:563-7.
7. Sherwood A, Hinderliter AL, Watkins LL, et al. Impaired endothelial function in coronary heart disease patients with depressive symptomatology. J AM Coll Cardiol 2005; 46:656-9.
8. Lesperance F, Frasure-Smith N, Theroux P, et al. The association between major depression and levels of soluble intercellular adhesion molecule 1, interleukin-6 and C- reactive protein in patients with recent acute coronary syndromes. Am J Psychiatry 2004;161:271-7.
9. Empana JP, Sykes DH, Luc G, et al. PRIME Study group. Contributions of depressive mood and circulation inflam- matory markers to coronary heart disease in healthy European men: the Prospective Epidemiological Study of Myocardial Infarction (PRME). Circulation 2005;111: 2299-305.
10. Frasure-Smith N, Lesperance F. Recent evidence linking coronary heart disease and depression. Can J Psychiatry 2006;51:730-7.
11. Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosom Med 2004; 66:802-13.
12. Van Melle JP, De Jonge P, Spijkerman TA, et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med 2004;66:814-22.
13. Lett HS, Blumenthal JA, Babyak MA, et al. Depression as a risk factor for coronary artery disease: evidence, mech- anisms, and treatment. Psychom Med 2004;66:305-15.
14. Frasure-Smith N, Lesperance F. Reflecitons on depression as a cardiac risk factor. Psychosom Med 2005;67:S19-25.
15. Kongsakon R, Zartrungpak S, Rotjanairunkit A, et al. The reliability and validity of Thai version of Montgomery Asberg Depression Rating Scale (MADRS). J Psychiatr Assoc Thailand 2003;48:211-9.
16. Barth J, Schumacher M, Hermann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a metaanalysis. Psychosom Med 2004;66: 802-13.
17. Smith NF, Lesperance F. Depression and anxiety as Pre- dictors of 2 year Cardiac events in patients with Stable Coronary Artery Disease. Arch Gen Psychiatry 2008;65: 62-71.