Effects of percutaneous coronary intervention on depressive symptoms in chronic stable angina patients

Abstract

Objective: Depression is present in 1 of 5 outpatients with coronary artery disease (CAD), and a well-documented risk factor for recurrent cardiac events and mortality. We examined the impact of percutaneous coronary intervention (PCI), on depressive symptoms, in chronic stable angina (CSA) patients.

Methods: On prospective and non-randomized trial, consecutive CSA patients (n=171), who had undergone coronary angiography from January 2006 to December 2007, were included. Patients were subdivided into PCI and non-PCI groups, and then completed 21-item the Beck Depression Inventory II (BDI-II), at the baseline and pre-discharge, to assess the depressive symptoms.

Results: A total of 108 (63%) patients were assigned to the non-PCI group, and 63 (37%) patients to the PCI group. Using an independent t-test, we found that patients with PCI were significantly older (non-PCI vs. PCI; 57±11 vs. 64±10, years, p<0.001), had more joint disease (12.0 vs. 27.0%, p=0.013), more stroke history (5.6 vs. 17.5%, p=0.012) and higher incident of family history of cardiovascular disease (28.7 vs. 46.0%, p=0.025), but less religion (54.6 vs. 36.5%, p=0.002) and private health insurance (43.5 vs. 20.6%, p=0.002). The mean difference of BDI-II score between the baseline and pre-discharge was higher in patients with PCI (OR: 1.266; 95% CI: 1.146-1.398, p<0.001).

Conclusion: In conclusion, PCI contributes independently to higher risk of developing depressive symptoms in CSA patients during hospitalization; Routine assessment and management of PCI related depressive symptoms are justified.

Keywords: Angioplasty; Coronary artery disease; Depression.

Figure 1

Comparison of measures of depression between non-PCI and PCI groups during hospitalization. PCI: percutaneous coronary intervention, BDI-II: Beck Depression Inventory II.