Last Updated: 2003-08-22 9:45:16 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Patients with depression are more than twice as likely to die after undergoing surgery to bypass blocked coronary arteries than patients without this mental illness, according to a new study.
While the link between depression and poor outcomes after heart bypass has been suspected, previous studies have not reached solid conclusions either because the number of patients studied was too small or they weren't followed for long enough, Dr. James A. Blumenthal told Reuters Health. "Our study involved more than 800 patients who were followed for up to 12 years," he explained.
Blumenthal and a team at Duke University Medical Centers in Durham, North Carolina, tracked 817 patients who underwent coronary artery bypass grafting between May 1989 and May 2001. The patients were tested of depression before surgery and six months after.
Subsequently, during follow-up that averaged 5 years, 122 patients died.
Over a third of the patients were found to have depression, the researchers report in this week's issue of the medical journal The Lancet.
After taking into account factors such as age, sex, diabetes, smoking, and number of grafts, the team found that moderate-to-severe depression before surgery increased the risk of death 2.4-fold. Similarly, depression that persisted from before surgery to 6 months after was linked to a 2.2-fold increased risk of dying.
The results suggest that "physicians need to be more cognizant of the potential importance of depression," Blumenthal noted. "In addition to looking at conventional cardiac risk factors, such as hypertension and smoking, physicians need to pay attention to a person's mental state."
He believes having a member of the bypass team screen patients for depression would be worthwhile. "Effective treatments for depression are available, but whether these treatments would actually improve survival after coronary bypass is unknown," Blumenthal pointed out. "But certainly improving quality of life would be a goal in and of itself."
