Impact of depression on clinical outcomes following percutaneous coronary intervention: a systematic review and meta-analysis.
Open accessAbstract
OBJECTIVES: The objective of this meta-analysis was to assess whether depression in percutaneous coronary intervention (PCI) patients is associated with higher risk of adverse outcomes. DESIGN: Systematic review and meta-analysis. METHODS: EMBASE, PubMed, CINAHL and PsycINFO were searched as data sources. We selected prospective cohort studies evaluating the relationship between depression and any adverse medical outcome, including all-cause mortality, cardiac mortality and non-fatal events, from inception to 28 February 2019. Two reviewers independently extracted information and calculated the risk of cardiovascular events in patients with preoperative or postoperative depression compared with non-depressed patients. RESULTS: Eight studies (n=3297) met our inclusion criteria. Most studies found a positive association between depression and adverse cardiovascular outcomes. Meta-analysis yielded an aggregate risk ratio of 1.57 (95% CI 1.28 to 1.92, p<0.0001) for the magnitude of the relation between depression and adverse outcomes. CONCLUSIONS: Our systematic review and meta-analysis suggests that depression is associated with an increased risk of worse clinical outcome or mortality in patients undergoing PCI. Assessment time and length of follow-up do not have a significant effect on this conclusion.
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Psychiatric symptoms and illnesses are associated with worse outcomes regarding the CVD, including poorer prognosis, lower quality of life, increased risk of mortality, and interference with CVD treatment.
“Psychiatric symptoms and illnesses are in turn associated with several worse outcomes regarding the CVD: poorer prognosis of the course of the CVD, lower quality of life (QoL), increased risk of mortality, and interference with the CVD treatment, for example, due to worse adherence (3, 7–11).”
From Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events (2022) · cites this paper as [10]
The Discussion reports that depressive symptoms were associated with worse clinical outcomes and higher mortality among patients undergoing PCI, supporting the prognosis and mortality portions of the claim. It does not establish those associations for psychiatric illnesses generally, nor does it link them to lower quality of life or interference with treatment through poorer adherence; its Introduction discusses improved quality of life after PCI, not its association with depression. (LLM, conf=0.88)
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References 39 · Cited by 53
- Authors
- Zhang, W. Y., Nan, N., Song, X. T., Tian, J. F., & Yang, X. Y.
- Affiliations
- Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
- Capital Medical University (CN)
- Corresponding author
- Song, Xian Tao
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2019-08
- Volume
- 9
- Issue
- 8
- Pages
- e026445
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC6707663
- OpenAlex
- W2969870189
- Cited by
- 53
- References
- 39
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 9 · 2023: 11 · 2022: 12 · 2021: 5 · 2020: 1
- FWCI
- 0.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Beijing Lab for Cardiovascular Precision Medicine
- China Cardiovascular Disease Alliance VG Youth Fund Project (2017- CCA-VG-007)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- depression, percutaneous coronary intervention, cardiovascular adverse events, all-cause mortality, cardiac mortality, non-fatal cardiovascular events, preoperative depression, postoperative depression, coronary artery disease
- MeSH terms
- Coronary Artery Disease, Depression, Humans, Postoperative Complications, Prognosis, Risk Factors, Outcome Assessment, Health Care, Percutaneous Coronary Intervention
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