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From Veterans Affairs Connecticut Healthcare System (M.M.B., M.C.B., R.S.), West Haven Campus, West Haven, Connecticut 06516; Section of Cardiovascular Medicine (R.S., M.M.B.); Yale University School of Medicine, New Haven, Connecticut 06510; and Mt. Sinai School of Medicine (M.M.B.), New York, New York 10029.
Address reprint requests to: Matthew M. Burg, PhD, VA Connecticut Healthcare System/116B4, 950 Campbell Ave., West Haven, CT 06516. Email: mburg{at}attglobal.net
Received for publication November 19, 2002; revision received April 22, 2003.
OBJECTIVES: Depression has been related to mortality in patients with CAD and to medical morbidity after CABG; however, prior studies have not examined the contribution of presurgical depressive symptoms to mortality after CABG. The purpose of this study was to determine the independent contribution of presurgical symptoms of depression to 2-year cardiac mortality after CABG.
METHODS: Eighty-nine consecutive veteran nonemergent CABG patients recruited between December 1996 and June 1998 completed the BDI 1 to 7 days before surgery. Mortality risk was assessed by medical co-morbidity and RIS.
RESULTS: Significant univariate contributions to two-year cardiovascular mortality were found for RIS (
2 = 6.57, p < .01), history of CHF (2 = 4.94, p < .02), history of COPD (2 = 5.19, p < .02), and elevated depressive symptoms (2 = 4.70, p < .03). The multivariate model revealed that the RIS (2 = 4.70, p < .03) and elevated depressive symptoms (2 = 3.86, p < .05) remained significant in the prediction of 2-year cardiovascular mortality, with no other variables being found significant.
CONCLUSIONS: Elevated depressive symptoms before CABG surgery appear to be an important independent contributor to long-term mortality. Future research should focus on replication with larger, more diverse samples, and identification of pathophysiological mechanisms.
Key Words: depression, • coronary artery bypass graft surgery, • prognosis.
Abbreviations: CABG = coronary artery bypass graft surgery;; CAD = coronary artery disease;; BDI = Beck Depression Inventory;; MI = myocardial infarction;; COPD = chronic obstructive pulmonary disease;; CHF = congestive heart failure;; RIS = Risk Index Score.
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