Study Finds That Depression After Bypass Surgery Raises Risk of Future Heart Problems

For immediate release: November 22, 2001

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Recovery after coronary artery bypass surgery depends as much on the patient's state of mind as it does on the condition of the patient's heart, according to researchers at the University of Maryland Medical Center and Columbia University College of Physicians & Surgeons. Their study evaluated the impact of depression on the health of men and women following bypass surgery. Results of the study are being published in the Lancet on November 24, 2001.

“Based on our findings, we believe that physicians and patients need to be aware of the increased risks faced by patients suffering depression,” says Ingrid Connerney, DrPH, director of Clinical Effectiveness at the University of Maryland Medical Center and a clinical assistant professor of surgery at the University of Maryland School of Medicine. “The next logical step is to determine the mechanisms responsible for these effects,” she adds.

The study included 309 patients (207 men and 102 women) who had bypass surgery at the University of Maryland Medical Center in Baltimore from March to November, 1997. The researchers looked at whether depression prior to leaving the hospital played a role in how well patients would do within a year following surgery.

“We found that depressed patients were more than twice as likely to experience a cardiac problem within the next 12 months than those who were not depressed,” says Richard Sloan. Ph.D., director of the Behavioral Medicine Program and professor in the department of psychiatry at Columbia University College of Physicians & Surgeons. “These problems included chest pain, heart failure requiring hospitalization, a heart attack, or the need for another cardiac procedure.”

The women in the study had double the risk of future cardiac events compared to the men. Women who were depressed had the highest risk. Almost half of the depressed women (44 percent) had a serious cardiac problem within a year after surgery, while 18 percent of the women who were not depressed had further problems. The study found that 20 percent of the depressed men had future heart problems, compared to only six percent of non-depressed men.

For the study, Dr. Connerney performed a detailed psychiatric interview with each patient prior to discharge from the hospital. The patients were assessed 12 months later.

“We looked at many factors, including the patient's age, gender, marital status, smoking behavior, and depression,” explains Dr. Connerney, “but it turned out that only depression, heart condition, and gender mattered, and they were of equal importance.”

The increased risk faced by depressed patients could not be explained by differences in demographics, severity of disease, or other factors. Also interesting was the fact that depression did not seem to affect subsequent hospital admissions for health conditions unrelated to cardiac problems.

Coronary artery bypass surgery is performed to help the heart pump blood around blocked arteries and to alleviate severe chest pain. About 20 percent of heart bypass patients suffer from depression in the hospital.

Also collaborating on the study with Dr. Connerney and Dr. Sloan were Peter Shapiro, M.D., of Columbia University College of Physicians & Surgeons, Emilia Bagiella, Ph.D. from the Mailman School of Public Health at Columbia University, and Joseph McLaughlin, M.D., of the University of Maryland School of Medicine.

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