Tom A J de Jager1, Karolijn Dulfer2, Sumant Radhoe1, Michael J Bergmann1, Joost Daemen1, Ron T van Domburg3, Mattie J Lenzen1, Elisabeth M W J Utens4. 1. Department of Cardiology, Thoraxcenter Erasmus Medical Centre, Rotterdam, The Netherlands. 2. Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands. 3. Department of Cardiology, Thoraxcenter Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: r.vandomburg@erasmusmc.nl. 4. Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands; Research Institute of Child Development and Education, University of Amsterdam/de Bascule-AMC, The Netherlands.
Abstract
BACKGROUND: Since the early 2000s the treatment of choice for an acute myocardial infarction has moved from thrombolytic therapy to primary PCI (pPCI). As a result, the majority of patients undergoing PCI shifted from stable angina pectoris (SA) to acute coronary syndrome (ACS). Additionally the previously observed association between depression and anxiety and long-term outcome in patients who underwent a PCI may have been changed. The main objective of this study was to investigate the predictive value of depression and anxiety for 10-year mortality, in a cohort with post-PCI patients treated for SA versus patients treated for ACS. METHODS: This prospective single center cohort consists of a consecutive series of patients (n=528) treated with PCI. At 1month post-PCI, patients completed the Dutch version of the Hospital Anxiety and Depression Scale (HADS). RESULTS: After adjustment for baseline characteristics depression was associated with higher 10-year mortality post-PCI (HR 1.58 95% Confidence Interval [95% CI] 1.04-2.40). In the ACS population no association between depression and 10-year mortality was found (HR 1.05 95% CI 0.62-1.79), in contrast to the SA population (HR 1.97 95% CI 1.09-3.57). After additional adjustment for anxiety, depression was no longer associated with higher mortality. CONCLUSIONS: Anxiety at baseline was associated with an increased 10-year mortality rate after PCI. Depression was also associated with higher 10-year mortality, however the association disappeared after additional adjustment for anxiety. This finding was more pronounced in patients presenting with SA as compared to those presenting with ACS, which might be a result of the increasing number of ACS patients treated with pPCI.
BACKGROUND: Since the early 2000s the treatment of choice for an acute myocardial infarction has moved from thrombolytic therapy to primary PCI (pPCI). As a result, the majority of patients undergoing PCI shifted from stable angina pectoris (SA) to acute coronary syndrome (ACS). Additionally the previously observed association between depression and anxiety and long-term outcome in patients who underwent a PCI may have been changed. The main objective of this study was to investigate the predictive value of depression and anxiety for 10-year mortality, in a cohort with post-PCI patients treated for SA versus patients treated for ACS. METHODS: This prospective single center cohort consists of a consecutive series of patients (n=528) treated with PCI. At 1month post-PCI, patients completed the Dutch version of the Hospital Anxiety and Depression Scale (HADS). RESULTS: After adjustment for baseline characteristics depression was associated with higher 10-year mortality post-PCI (HR 1.58 95% Confidence Interval [95% CI] 1.04-2.40). In the ACS population no association between depression and 10-year mortality was found (HR 1.05 95% CI 0.62-1.79), in contrast to the SA population (HR 1.97 95% CI 1.09-3.57). After additional adjustment for anxiety, depression was no longer associated with higher mortality. CONCLUSIONS:Anxiety at baseline was associated with an increased 10-year mortality rate after PCI. Depression was also associated with higher 10-year mortality, however the association disappeared after additional adjustment for anxiety. This finding was more pronounced in patients presenting with SA as compared to those presenting with ACS, which might be a result of the increasing number of ACS patients treated with pPCI.
Authors: Nina Rieckmann; Konrad Neumann; Sarah Feger; Paolo Ibes; Adriane Napp; Daniel Preuß; Henryk Dreger; Gudrun Feuchtner; Fabian Plank; Vojtěch Suchánek; Josef Veselka; Thomas Engstrøm; Klaus F Kofoed; Stephen Schröder; Thomas Zelesny; Matthias Gutberlet; Michael Woinke; Pál Maurovich-Horvat; Béla Merkely; Patrick Donnelly; Peter Ball; Jonathan D Dodd; Mark Hensey; Bruno Loi; Luca Saba; Marco Francone; Massimo Mancone; Marina Berzina; Andrejs Erglis; Audrone Vaitiekiene; Laura Zajanckauskiene; Tomasz Harań; Malgorzata Ilnicka Suckiel; Rita Faria; Vasco Gama-Ribeiro; Imre Benedek; Ioana Rodean; Filip Adjić; Nada Čemerlić Adjić; José Rodriguez-Palomares; Bruno Garcia Del Blanco; Katriona Brooksbank; Damien Collison; Gershan Davis; Erica Thwaite; Juhani Knuuti; Antti Saraste; Cezary Kępka; Mariusz Kruk; Theodora Benedek; Mihaela Ratiu; Aleksandar N Neskovic; Radosav Vidakovic; Ignacio Diez; Iñigo Lecumberri; Michael Fisher; Balazs Ruzsics; William Hollingworth; Iñaki Gutiérrez-Ibarluzea; Marc Dewey; Jacqueline Müller-Nordhorn Journal: Health Qual Life Outcomes Date: 2020-05-14 Impact factor: 3.186