Table 4.
Summary of studies assessing depression after percutaneous coronary artery intervention
| Country Author | Patients and rating scale | Results | Conclusions |
|---|---|---|---|
| Netherland Pedersen et al., 2006[39] |
692 patients 6 and 12 months after PCI HADS |
471 (68.1%) had no symptoms of anxiety nor depression, 62 (9.0%) had anxiety only, 59 (8.5%) had depressive symptoms only, and 100 (14.5%) had co-occurring symptoms | Patients with co-occurring anxiety and depression reported poorer health status compared with anxious or depressed only patients and no-symptom patients. Anxiety has incremental value to depressive symptoms in identifying PCI patients at risk for impaired health status |
| Poland Dudek et al., 2007[55] |
156 patients with optimal PCI result Depression=HDRS21 >10/BDI >11 |
75 (48.1%) patients had depression before PCI which persisted in 38 Patients 1 month after PCI. 81 (51.9%) patients did not have depression before PCI but 12 of them were depressed 1 month after PCI |
No significant correlations between cardiovascular function impairment (CCS criteria) and severity of depressive symptoms |
| India Chaudhury and Srivastava, 2013[41] |
35 patients assessed before and 3 days after PCI with HADS | Depression at baseline 11.4 (2.7) was significantly >3 days after PCI 7.2 (1.9) | Successful PTCA resulted in significant reduction in depression |
| Brazil Furuya et al., 2013[42] |
59 patients assessed 2-7 months after PCI HADS |
Depression found in 14.8% men and 43.7% women | Women had significantly higher prevalence of depression compared to men |
| Austria Sipötz et al., 2013[43] |
163 PCI patients HADS after intervention and at 1,6,12 and 24 months |
HADS-Total score decreased significantly from baseline to 1 month follow-up (P=0.02). No significant change thereafter | Mental distress declined during the first month of the follow-up period. MacNew HRQOL is negatively correlated to mental distress |
| Turkey Ekici et al., 2014[44] |
225 patients undergoing elective PCI divided into 3 groups as per their Gensini score: normal coronary arteries (Gensini score 0, n=78, control group), minimal CAD (Gensini score 1-19, n=54), and significant CAD (Gensini score ≥20, n=93); HADS | Depression scores: Control group=4.0 (2.0-6.5) Minimal CAD=5.0 (3.0-7.5) Significant CAD=5.5 (3.0-9.0) P=0.322 (Not significant) |
A significant positive correlation was found between HADS-anxiety and Gensini scores (r=0.156, P=0.019) |
| Iran Moattari et al., 2014[45] |
Experimental group (n=40) underwent a 12 weeks angina plan intervention consisting of 30 min counseling interview and telephone follow up at the end of 1,4,8 and 12 weeks. HADS at pretest and 3 months after PCI | Depression scores experimental group: Pretest 5.92±2.65; 3 months after PTCA 5.52±3.13 Control group: Pretest 4.90±2.91; 3 months after PTCA 4.77±2.61 |
Mean changes between two groups was not significant |
| Iran Sharif et al., 2014[46] |
Experimental group participated in a 30-min training session before and after PTCA and an informative booklet at discharge. Control group received routine oral instructions before and after angioplasty and an informative pamphlet at discharge DASS on admission, at discharge, and 1 month after discharge |
Depression scores Experimental group T1=5.00±3.44; T2=4.45±3.31; T3=2.45±2.49 Control group: T1=4.85±3.02; T2=4.97±3.04; T3=5.95±3.76 Experimental group T1-T3 P<0.001 Experimental group T3-control group T3 P<0.001 |
A planned discharge program in patients undergoing PTCA lowered their depression |
| Poland Uchmanowicz and Łoboz-Grudzień 2015[47] |
90 patients (55 men, 35 women) aged 39-84 undergoing coronary angioplasty. BDI in first week, after 6 months and 36 months | An analysis of the dynamics of changes in the severity of depressive symptoms according to the BDI shows an increase from 4.6 in the first week to 10.4 points in the 36th month (P<0.001) | More attention should be paid to depression after PCI to improve QOL |
| China Lv et al., 2016[48] |
75 anxiety and depression patients after PCI randomly divided into CBT group (n=38) and control group (n=37). HAMD, HAMA, Chinese version, before, 3 days, and 8 weeks after PCI | HAM D scores in treatment and control group before treatment was (19.5±6.8 and 19.0±7.9, P=0.77) which decreased to (11.7±4.5 and 15.1±3.9; P=0.001) respectively after 8 weeks | HAM-A scores were decreased after treatment, but were more substantially reduced in patients that underwent CBT than those in the control group |
| Iran Pournaghash-Tehrani and Abdoli-Bidhendi 2016[49] |
90 patients undergoing PTCA. DASS 21 1 day before and 2 months after PTCA | There was a significant reduction of depression from pre PTCA to post PTCA in men (12.86±3.66-9.18±3.32) and women (12.26±4.18-8.60±3.42) respectively | PTCA was associated with improvement in depression of the patients |
| China Gu et al., 2016[50] |
170 randomly selected CHD patients undergoing PCI. HADS 1 day prior and after PCI, and at 1,3,6 and 12 months after PCI | PCI significantly associated with depression, and comorbid anxiety and depression (χ2=54.45, 64.83; P<0.01) at each follow-up | Depression, and comorbid anxiety and depression significantly increases 1 day before and after PCI; but significantly decreases with time following PCI |
| Colombia Della-Méa et al., 2018[52] |
266 patients who had undergone PCI; 68% men; average age 64.5 years (SD=8.9 years); Beck depression inventory II after PCI | 51.9% patients had minimal depression; 25.9% mild depression; 12.8% moderate depression; and 9.4% patients had severe depression | Assessing and treating psychological symptoms after PCI may improve patient’s adherence to treatment and their QOL |
| Norway Olsen et al., 2018[53] |
775 patients undergoing first time PCI at baseline and at 3 years follow up HADS | 27% and 19% of patients undergoing PCI reported symptoms of anxiety and depression | After 3 years, patients had higher level of anxiety, but not depression, than the reference population. Older age, lower-education and previous cardiovascular morbidity are associated with depression |
HADS – Hospital Anxiety and Depression Scale; DASS – Depression Anxiety Stress Scale; HDRS – Hamilton depression Rating; Scale; BDI – Beck depression inventory; PCI – Percutaneous coronary artery intervention; CAD – Coronary artery disease; PTCA – Percutaneous transluminal coronary angioplasty; CHD – Coronary heart disease; QOL – Quality of life; HRQOL – Health related QOL; MHRQOL – MacNew HRQOL; CBT – Cognitive behaviour therapy; CCS – Canadian cardiovascular society; HAMD – Hamilton depression rating scale; HAMA – Hamilton anxiety rating scale