Depression Following CAD Diagnosis Linked to 2-Fold Mortality Risk

A depression diagnosis following coronary artery disease (CAD) diagnosis is associated with a 2-fold higher mortality risk, according to the results of a recent study.

While depression is a known risk factor for cardiovascular disease (CVD), whether or not subsequent depression diagnosis in patients who have experienced a CVD diagnosis or event is related to greater mortality is unknown.
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In their study, the researchers used International Classification of Diseases codes to verify depression diagnosis in 24,137 patients with angiographically determined CAD. They used depression diagnosis as a time-varying covariate predicting mortality in multivariable Cox hazard regression models.

Overall, 3646 patients had a depression diagnosis during follow-up. Those with depression were significantly younger and more likely to be female, have diabetes, and have had a previous depression diagnosis.

Death occurred in 50% of patients with depression and 38% of patients without depression, with post-CAD depression diagnosis being the strongest predictor of death (Hazard ratio [HR] 2.00). This association was also true among subgroups with no prior depression diagnosis (HR 2.00) and in patients with stable angina (HR 1.84), unstable angina (HR 2.25), and myocardial infarction (HR 2.09).

“A depression diagnosis at any time following CAD diagnosis was associated with a two-fold higher risk of death,” the researchers concluded.

—Michael Potts

Reference:

May HT, Horne BD, Knight S, et al. The association of depression at any time to the risk of death following coronary artery disease diagnosis [published online July 26, 2017]. Eur Heart J Qual Care Clin Outcomes. doi: https://doi.org/10.1093/ehjqcco/qcx017.