Depression is known to be associated with at least doubling the risk of cardiac events over 1 to 2 years after an acute myocardial infarction (MI). However, less is known about the prevalence and prognosis of depression in outpatient samples especially in short-term follow-up studies in stable coronary artery disease (CAD) patients. The purpose of this study was to evaluate the relationship between depressive disorders and short term risk of major adverse cardiovascular events (MACEs) in stable coronary artery disease patients.
This prospective study included 134 stable CAD patients at the cardiovascular out patient depart- ment (OPD) clinic at Bangkok Metropolitan Administration (BMA) Medical College and Vajira Hospital. The Thai equivalent of the Montgomery-Asberg Depression Rating Scale (MADRS) score was used. After 6 months, all patients were assessed for major adverse cardiovascular events (MACEs).
15% of the sample had a depressive condition (MADRS score > 10), yet less than half of them (20%) had been treated with anxiolytic medications. After the 6 months follow-up period, there were no cases reported of cardiac death in either group. Myocardial infarction was seen in the normal MADRS group [Four cases (3.5%)] but none appeared in the group diagnosed with depressive conditions. Two cases (10%) of those with depressive conditions and seven cases (6.10%) of the normal MADRS group had percutaneous transluminal coronary angioplasty (PTCA); p = 0.525. CABG or stroke was not found in either group. There was no statistically significant different incidences of MACEs (cardiac death, MI, PTCA, CABG, stroke) in either group (10% vs. 9.6%; p = 0.961).
There was no statistically significant difference in the short term MACEs between the two groups (those with and without depressive conditions) in this study.
depression, stable coronary artery disease, major cardiovascular events