Patients with mood disorders and chronic coronary artery disease receiving conservative therapy have a higher risk of death during affective episode

Abstract

The contribution of comorbid with coronary artery disease (CAD) mood disorders (MD) into total mortality is contradictory.

Objective

To study frequency and time until death due to general causes in groups of patients with comorbid MD, and without them as well as interrelationship of these indicators with comorbid MD and therapy with antidepressants.

Methods

Inpatients with chronic CAD (n = 333) under conservative therapy were investigated (31% females (n = 103), 69% males (n = 230), mean age 61.8 ± 9.8 years). Team of cardiologists and psychiatrists followed up patients for 7 years (2008–2014). Survival frequency was evaluated by method of life tables.

Results

Among patients under conservative therapy of CAD the death frequency due to general causes did not differ significantly in presence (n = 80) and absence of MD (n = 253) and was 18.8% and 16.6%, respectively. Correlation of deaths with hypomanic and mixed episodes was revealed (rs = 0.3). The groups differed according to function of immediate risks: patients with MD were at high risk of death during the year after detection of affective symptoms, and in group without MD it increased over the time of observation (Р = 0.0000).

Duration of antidepressant therapy was 5.5 ± 0.5 months. Among patients receiving antidepressants (n = 20), during therapy and after one month after discontinuation there were not deaths. Difference of function of immediate risks in these subgroups was not significant (Р = 0.09).

Conclusions

Patients with affective disorders and chronic CAD under conservative therapy are at high risk of death within affective episode and therapy with antidepressants did not influence change of risk of death.

Disclosure of interest

The authors have not supplied their declaration of competing interest.