Depressed Stent Patients At Added Risk

Coronary stent patients with depression at heightened risk of dying

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Patients who receive coronary stents to prop open blocked arteries are at an added long-term risk of dying if they suffer from depression.

Depression had previously been linked to worse outcomes among coronary artery disease patients, but most previous research has examined short-term risk.

"Make an appointment with a psychiatrist if you suspect depression."

Nikki Damen, lead author and a doctoral student at Tilburg University in the Netherlands, said that doctors and nurses typically focus on medical factors such as diabetes or a family history of heart disease in assessing a stent patients' risk of death. She noted that is not the whole picture, explaining that psychological factors also can affect a patient's prognosis.

Researchers followed 1,234 patients between the ages of 26 and 90 years old who received angioplasty to open blocked arteries and a stent from the Rapamycin- Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry. The average patient age was 62. The new research tracks patients over a period of seven years.

Participants were then assessed for depression six months after stent implantation using the Hospital Anxiety and Depression Scale (HADS). They were followed for seven years.

About 26 percent of patients were found to be depressed, and 15 percent of patients had died by the end of the study. Of the depressed patients, 24 percent died from any cause as compared to 12 percent of non-depressed patients.

Investigators found that depressed stent patients were 1.5 times more likely to have died than those who did not suffer from depression. This was independent of other factors such as age, gender, clinical characteristics and anxiety level.

Taking statins to lower blood pressure was associated with a reduced risk of dying, while patients who were male, older or suffering from diabetes were found to be at a significantly increased risk of dying.

Researchers are not certain of the cause, but suggest that depressed patients may lead less healthy lifestyles, such as smoking, drinking alcohol, living a sedentary lifestyle and eating a poor diet. Investigators indicated another possibility is that depression may alter the activity of the sympathetic nervous system, leading to increases in heart rate and blood pressure.

"More research is needed to determine how to screen for depression in cardiovascular patients, and then how to provide treatment," Damen said.

The research was presented at the 12th Annual Spring Meeting on Cardiovascular Nursing on March 16 in Copenhagen, Denmark.

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Review Date: 
March 15, 2012
Last Updated:
March 20, 2012