Depression and the risk of adverse outcomes at 5 years in patients with coronary heart disease.

BACKGROUND

Cardiovascular diseases are a public health concern worldwide, with high rates of morbidity and mortality. Depression is a frequent comorbidity in coronary heart disease (CHD). It can be caused by the experience of suffering from heart disease, but it can also influence the prognosis of the CHD. The prevalence of depression in patients with cardiovascular disease is twice as high as that in the general population.

AIM

Assess the influence of depression in the prognosis at 5 years in patients with CHD.

METHODS

145 patients diagnosed with CHD were recruited between September 2013 and June 2015. Depression was assessed based on the PHQ-9 results at the time of hospitalization and 3 months after discharged. Sociodemographic and clinical variables were collected. A 5-year follow-up was carried out to verify death, reinfarction or any adverse outcome.

RESULTS

20% of the study population had depression at hospital admission compared with 11% at 3 months. Depression at 3 months after discharged was a differentiating factor to present complications (42.6 months, CI 95% 27.3-57.9) compared with patients without depression (55 months, CI 95%, 50.9-59.1) (Log-Rank 0.034). In the unadjusted model, the risk of heart complications increased with patients that have comorbidities, such as diabetes (HR 2.78, 95% CI 1.21-6.3) or hypothyroidism (HR 2.5 95% CI 1.09-5.7). Also, patients with post-hospitalization depression at 3 months were 3 times (95% CI 1.023-8.8) more likely to have complications during the follow-up period than nondepressed patients. After risk factor adjustment, the HR for depression was 2.01 (95% CI 0.57-6.9).

FINDINGS

Patients with depression at 3 months following the coronary event, presented complications sooner than those without depression.