Depressive symptoms in coronary artery disease inpatients after the successful coronary angioplasty

Abstract

Background:

Studies confirm a strong relationship between depression and coronary artery disease (CAD).

Aims:

To investigate the spectrum and course of depressive symptoms in CAD patients before and after the successful coronary angioplasty (PCI) in one year follow-up.

Methods:

227 patients with CAD selected for PTCA were enrolled. 156 patients with full clinical and angiographic success and without restenosis within 4 weeks after the intervention were included in further analysis. Patients' status was assessed four times (one day before and at 1, 6 and 12 months after the intervention), with Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RS), Beck Hopelessness Scale (HS), Automatic Thoughts Questionnaire (ATQ).

Results:

Mild and moderate depressive disorders with the prevalence of nonspecific somatic symptoms were observed one day before PTCA in 75 (48%) patients. One month after the PCI, depressive symptoms persisted in 33 subjects. Moreover in group of patients who were free of depressive symptoms a day before PTCA, twelve patients (15%) developed depressive symptomatology. Depressive symptoms and depressive disorders of thinking (especially hopelessness) recognized 4 weeks after PTCA had a tendency to persist at 6 and 12 months. The tendency was associated with more severe affective-cognitive and somatic symptoms of the depressive syndrome, more frequent negative automatic thoughts and stronger hopelessness detected at the beginning of the study.

Conclusions:

The results suggest that successful PCI is not sufficient determinant for the improvement of depressive symptoms. Diagnosis of depression in CAD patients needs a special attention, because of tendency to persistence.