May HT, et al. – This study was performed among patients with existing coronary artery disease (CAD) to assess the link between a subsequent depression diagnosis and all–cause mortality. Findings demonstrated that a link was apparent, between a depression diagnosis at any time following CAD diagnosis and a two–fold higher risk of death.

Methods

• Researchers studied patients (N = 24 137) who had angiographically determined CAD (stenosis ≥70%).
• In addition, depression after CAD diagnosis was determined by International Classification of Diseases codes and evaluated as a time-varying covariate predicting mortality in multivariable Cox hazard regression models to control for patients’ differing lengths of time between CAD diagnosis and depression diagnosis.

Results

• Findings reported that a total of 3646 (15%) had a depression diagnosis during follow-up.
• Data revealed that compared with those without depression, these patients were significantly younger (64 ± 12 vs. 65 ± 12 years), more often female (37% vs. 24%), diabetic (40% vs. 30%), previously diagnosed with depression (26% vs. 5%), and less likely to present with an myocardial infarction (MI) (28% vs. 36%).
• Researchers noted that death (mean follow-up: 9.7 ± 6.1 years) occurred in 40% of patients (depression: 50% vs. no depression: 38%, P < 0.0001).
• They observed that after adjustment, post-CAD depression was the strongest predictor of death (HR = 2.00, P < 0.0001).
• In addition, they found that this link persisted among subgroups with no prior depression diagnosis (HR = 2.00, P < 0.0001) and by angiography indication: stable angina (HR = 1.84, P < 0.0001), unstable angina (HR = 2.25, P < 0.0001), and MI (HR = 2.09, P < 0.0001).