The First Affiliated Hospital Zhengzhou University, Biological Psychiatry International Joint Laboratory of Henan/Zhengzhou University, Henan Psychiatric Transformation Research Key Laboratory/Zhengzhou University, Zhengzhou, 450052, China.
Department of Cardiology, Peking University people's Hospital, Beijing, 100201, China.
J Affect Disord. 2020 Apr 1;266:158-164. doi: 10.1016/j.jad.2020.01.136. Epub 2020 Jan 26.
Depression is correlated with poor prognosis in patients with coronary artery disease (CAD). The goal of this meta-analysis was to assess the influence of depression on the risks of major adverse cardiovascular events (MACEs) and all-cause mortality after percutaneous coronary intervention (PCI).
Cohort studies were obtained by searching PubMed and Embase databases. Cohort studies regarding the association between depression and risks of MACEs and mortality after PCI were included. Heterogeneity was determined using the Cochrane's Q test and calculated using I. A fixed-effect model was used if no significant heterogeneity was detected; otherwise a random-effect model was applied. The adjusted risk ratio [RR] for the incidences of MACEs and all-cause mortality in patients with depression were compared to those without depression.
Nine cohorts including 4,555 CAD patients who underwent PCI were included in this meta-analysis, and 1,108 of these patients were diagnosed with depression. There were no significant differences among studies evaluating MACEs and mortality risks (I = 25% and 0%, respectively). Pooled results showed that depression was associated with higher risk of MACEs (RR: 2.10, 95% confidence interval [CI]: 1.59 to 2.77, p < 0.001) and all-cause mortality (RR: 1.76, 95% CI: 1.45 to 2.13, p < 0.001) during follow-up after PCI.
Available full text peer reviewed studies were limited and only studies in English were included in this analysis.
Depressive symptoms were independently associated with adverse cardiovascular outcomes in patients who received PCI. Psychological therapy that does not increase cardiac burden or induce pharmacological side effects may be a better strategy to treat depression associated with PCI.
抑郁症与冠心病（CAD）患者的预后不良相关。本荟萃分析的目的是评估抑郁对经皮冠状动脉介入治疗（PCI）后主要不良心血管事件（MACE）和全因死亡率的影响。
通过搜索 PubMed 和 Embase 数据库获得队列研究。纳入了关于抑郁与 PCI 后 MACE 风险和死亡率之间关系的队列研究。使用 Cochrane's Q 检验和 I ²来确定异质性。如果未检测到显著异质性，则使用固定效应模型；否则使用随机效应模型。比较抑郁患者和非抑郁患者的 MACE 发生率和全因死亡率的调整风险比（RR）。
本荟萃分析纳入了 9 项队列研究，共 4555 例接受 PCI 的 CAD 患者，其中 1108 例患者被诊断为抑郁症。评估 MACE 风险和死亡率的研究之间没有显著差异（I²分别为 25%和 0%）。汇总结果显示，抑郁与 PCI 后 MACE 风险（RR：2.10，95%置信区间 [CI]：1.59 至 2.77，p<0.001）和全因死亡率（RR：1.76，95% CI：1.45 至 2.13，p<0.001）升高相关。
可用的全文同行评审研究有限，且本分析仅纳入了英语研究。
抑郁症状与接受 PCI 的患者的不良心血管结局独立相关。不会增加心脏负担或引起药物副作用的心理治疗可能是治疗与 PCI 相关的抑郁的更好策略。
