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Depression after CAD diagnosis may increase risk for death
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Patients who were diagnosed with depression at any time after a CAD diagnosis had a twofold increased risk for death, according to a study published in European Heart Journal - Quality of Care & Clinical Outcomes.
“We’ve completed several depression-related studies and been looking at this connection for many years,” Heidi T. May, PhD, MSPH, a cardiovascular epidemiologist at the Intermountain Medical Center Heart Institute in Salt Lake City, said in a press release. “The data [show] that if you have heart disease and depression and it’s not appropriately treated in a timely fashion, it’s not a good thing for your long-term well-being.”
Researchers analyzed data from 24,137 participants diagnosed with significant CAD, defined as 70% or greater stenosis in at least one major coronary artery. ICD codes and CAD hospitalization after discharge determined a follow-up depression diagnosis. The outcome of interest was all-cause mortality. Participants were followed up for a median of 8.9 years.
Depression after a CAD diagnosis (median time, 3.2 years) was observed in 15% of participants. Compared with participants without depression, those diagnosed with depression at follow-up were more likely to be younger (63.9 years vs. 64.9 years), women (37% vs. 24%), previously diagnosed with depression (26.1% vs. 4.9%) and diabetic (40% vs. 30.3%). Participants diagnosed with depression were less likely to have presented with an MI (28.3% vs. 35.5%).
At a mean follow-up of 9.7 years, 49.9% of participants diagnosed with depression and 38.2% of those not diagnosed died (P < .0001). The strongest predictor of death was the diagnosis of depression after CAD (HR = 2; 95% CI, 1.89-2.11), after adjustment for risk factors, characteristics and follow-up events.
“Even a depression diagnosis years after a heart disease diagnosis increases a person’s risk for dying,” May said in an interview with Cardiology Today.
The link between a depression diagnosis after CAD and death was evident in those who were not diagnosed (HR = 2; P < .0001) and in participants with an angiographic indication of MI (HR = 2.09; P < .0001), stable angina (HR = 1.84; P < .0001) and unstable angina (HR = 2.25; P < .0001).
“Screening for depression needs to be ongoing, just like we continue to screen for cholesterol and [BP],” May said. – by Darlene Dobkowski
For more information:
Heidi T. May, PhD, MSPH, can be reached at heidi.may@imail.org.
Disclosures: The authors report no relevant financial disclosures.
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