Study Also Shows That Being A Woman Increases The Risk
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 and Surgeons. The study, which looked at both men and women, is the first of its kind to evaluate the impact of depression on women following bypass surgery.
Results will be presented at the annual meeting of the American Psychosomatic Society in Savannah, GA, on March 2, by principal investigator Dr. Ingrid Connerney.
The study included 309 patients (207 men and 102 women) who had bypass surgery at the University of Maryland Medical Center in Baltimore. The researchers looked at whether depression prior to leaving the hospital played a role in how well they would do within a year following surgery. They found that depressed patients were at least three times more likely to experience a cardiac problem within the next 12 months than those who were not depressed. Such problems included chest pain, heart failure requiring hospitalization, a heart attack, or the need for another cardiac procedure.
The researchers also found that the women in the study had a three times greater risk of future cardiac events than the men. Women who were depressed had the highest risk. Almost half of the depressed women (47 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 21 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 in a follow up 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 women could not be explained by differences in demographics, severity of disease, or other factors," she adds.
"Based on our findings, we believe that physicians and patients need to be aware of the increased risks faced by patients suffering depression," says Dr. Connerney. "The next logical step is to investigate whether treatment of depression lessens the risk of future cardiac events."
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.
In addition to Dr. Connerney, Peter Shapiro, M.D., and Richard Sloan, Ph.D., of Columbia University College of Physicians and Surgeons, and Joseph McLaughlin, M.D., of the University of Maryland School of Medicine, also collaborated on the study.