2-Nov-02

 

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Embargoed for Release:
Nov. 1, 2002

DEPRESSION AFTER BYPASS SURGERY LINKED TO LATER PROBLEMS

HEALTH BEHAVIOR NEWS SERVICE

Patients who are depressed one month after undergoing bypass surgery are more likely to have chest pain and other cardiac problems five years after the surgery, says new research.

This finding, published in the November-December issue Psychosomatics, was more pronounced in men than in women.

"Previous research suggests that one-third of coronary artery bypass patients are depressed at some point shortly after surgery and that depression leads to poorer outcomes," says lead author Louis Borowicz Jr., M.S., of the Johns Hopkins Hospital in Baltimore. "Our findings suggest specifically that depression one month after coronary bypass surgery is an important risk factor for continued cardiac problems, especially angina."

Therefore, the researchers suggest, long-term outcomes after coronary artery bypass surgery might be enhanced if patients were evaluated for depression one month after surgery and if needed depression treatment was provided.

For the study, 172 patients were interviewed before coronary artery bypass grafting and again at one month, one year and five years post-surgery. At each point, the researchers used a standard questionnaire to assess the study participants' level of depression and obtained detailed medical histories. Five years after surgery, data for 117 of the original 172 patients were available for analysis.

The researchers found that 32 percent of the patients were depressed before surgery, 28 percent were depressed one month after surgery, 21 percent were depressed one year after surgery, and 16 percent were depressed five years after surgery.

Higher depression scores at all four points were associated with cardiac chest pain at year five, with the strongest association found at one month after surgery. The association between depression and cardiac problems existed even when demographic, medical and surgical factors were controlled.

Unexpectedly, the researchers found a strong relationship between depression one month after surgery and cardiac outcomes in men but not in women. Five years post-surgery, both depressed and non-depressed women reported approximately the same, relatively high level of chest pain. Women were only 38 of the original 172 patients, however.

An estimated 800,000 coronary artery bypass grafting surgeries are performed each year worldwide, the authors report.

The research was supported by the Research Network on Successful Aging of the John D. and Catherine T. MacArthur Foundation, the Charles A. Dana Foundation, the Seaver Institute, and the National Institute of Neurological Disorders and Stroke.

---Health Behavior News Service