Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Psychiatry Investig. 2012 Sep;9(3):252-6. doi: 10.4306/pi.2012.9.3.252. Epub 2012 Sep 6.
Depression is present in 1 of 5 outpatients with coronary artery disease (CAD), and a well-documented risk factor for recurrent cardiac events and mortality. We examined the impact of percutaneous coronary intervention (PCI), on depressive symptoms, in chronic stable angina (CSA) patients.
On prospective and non-randomized trial, consecutive CSA patients (n=171), who had undergone coronary angiography from January 2006 to December 2007, were included. Patients were subdivided into PCI and non-PCI groups, and then completed 21-item the Beck Depression Inventory II (BDI-II), at the baseline and pre-discharge, to assess the depressive symptoms.
A total of 108 (63%) patients were assigned to the non-PCI group, and 63 (37%) patients to the PCI group. Using an independent t-test, we found that patients with PCI were significantly older (non-PCI vs. PCI; 57±11 vs. 64±10, years, p<0.001), had more joint disease (12.0 vs. 27.0%, p=0.013), more stroke history (5.6 vs. 17.5%, p=0.012) and higher incident of family history of cardiovascular disease (28.7 vs. 46.0%, p=0.025), but less religion (54.6 vs. 36.5%, p=0.002) and private health insurance (43.5 vs. 20.6%, p=0.002). The mean difference of BDI-II score between the baseline and pre-discharge was higher in patients with PCI (OR: 1.266; 95% CI: 1.146-1.398, p<0.001).
In conclusion, PCI contributes independently to higher risk of developing depressive symptoms in CSA patients during hospitalization; Routine assessment and management of PCI related depressive symptoms are justified.
冠心病（CAD）患者中有 1/5 存在抑郁症状，抑郁是心脏事件复发和死亡的一个明确的危险因素。我们研究了经皮冠状动脉介入治疗（PCI）对慢性稳定型心绞痛（CSA）患者抑郁症状的影响。
在一项前瞻性、非随机试验中，纳入了 2006 年 1 月至 2007 年 12 月接受冠状动脉造影的连续 CSA 患者（n=171）。将患者分为 PCI 组和非 PCI 组，然后在基线和出院前使用 21 项贝克抑郁量表第二版（BDI-II）评估抑郁症状。
共有 108 名（63%）患者被分配到非 PCI 组，63 名（37%）患者被分配到 PCI 组。通过独立 t 检验，我们发现 PCI 组患者年龄明显较大（非 PCI 组 vs. PCI 组；57±11 岁 vs. 64±10 岁，p<0.001），合并关节炎的比例更高（12.0% vs. 27.0%，p=0.013），有脑卒中病史的比例更高（5.6% vs. 17.5%，p=0.012），有心血管疾病家族史的比例更高（28.7% vs. 46.0%，p=0.025），而宗教信仰的比例更低（54.6% vs. 36.5%，p=0.002），有私人医疗保险的比例更低（43.5% vs. 20.6%，p=0.002）。PCI 组患者的 BDI-II 评分在基线和出院前的平均差值更高（OR：1.266；95% CI：1.146-1.398，p<0.001）。
综上所述，PCI 独立导致 CSA 患者住院期间发生抑郁症状的风险增加；应对 PCI 相关抑郁症状进行常规评估和管理。
