Major depressive disorder predicts cardiac events in patients with coronary artery disease.

TLDR

The study examines how major depressive disorder may lead to subsequent cardiac events in patients with coronary artery disease. The authors interviewed 52 CAD patients with structured psychiatric assessments before catheterization and followed them for 12 months to record myocardial infarction, angioplasty, bypass surgery, and death. Major depressive disorder emerged as the strongest independent predictor of major cardiac events over 12 months, regardless of CAD severity, left ventricular ejection fraction, or smoking status.

Abstract

Fifty-two patients undergoing cardiac catheterization and subsequently found to have significant coronary artery disease (CAD) were given structured psychiatric interviews before catheterization. Nine of these patients met criteria for major depressive disorder. All 52 patients were contacted 12 months after catheterization, and the occurrence of myocardial infarction, angioplasty, coronary bypass surgery and death was determined. Results of the study show that major depressive disorder was the best predictor of these major cardiac events during the 12 months following catheterization. The predictive effect was independent of the severity of CAD, left ventricular ejection fraction, and the presence of smoking. Furthermore, with the exception of smoking, there were no statistically significant differences between those patients with major depressive disorder and the remaining patients on any variable studied. The possible mechanisms relating major depressive disorder to subsequent cardiac events are discussed. It is concluded that major depressive disorder is an important independent risk factor for the occurrence of major cardiac events in patients with CAD.