Author + information
- Heidi Thomas May,
- Benjamin Horne,
- Stacey Knight,
- Kirk Knowlton,
- Tami Bair,
- Donald Lappe,
- Viet Le and
- Joseph B. Muhlestein
Background: Depression is a risk factor for CV disease incidence, recurrent events, and death. However, the impact between length of time following a CV event to depression on recurrent outcomes is unknown.
Methods: Patients (N=24,137) who had angiographically determined CAD (stenosis ≥70%) were studied. Depression was determined by ICD codes. Depression was evaluated as a time-varying covariate in multivariable Cox hazard regression models to control for the differing lengths of time between CAD diagnosis and depression diagnosis among patients. Patients were followed for 9.7±6.1 years for the occurrence of death.
Results: A total of 3,646 (15%) had a follow-up depression diagnosis. Compared to those without depression, these patients were significantly younger (64±12 vs. 65±12 years), more often female (37% vs. 24%), had diabetes (40% vs. 30%), a prior depression diagnosis (26% vs. 5%), and less often presented with an MI (28% vs. 36%). Death occurred in 40% of patients (depression 50% vs. no depression: 38%, p<0.0001). After adjustment, follow-up depression was the strongest predictor of death (Figure). This association persisted among those with no prior depression diagnosis (HR=2.00, p<0.0001) and by angiography indication: stable angina (HR=1.84, p<0.0001), unstable angina (HR=2.25, p<0.0001), and MI (HR=2.09, p<0.0001).
Conclusion: A depression diagnosis at any time following CAD diagnosis was found to be associated with a 2-fold increased risk of death.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Traditional and Novel Factors Used to Assess the Risk of, and Used for the Treatment of, Coronary Artery Disease
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1126-318
- 2017 American College of Cardiology Foundation