Depression and Angina Among Patients Undergoing Chronic Total Occlusion Percutaneous Coronary Intervention: The OPEN-CTO Registry

JACC Cardiovasc Interv. 2019 Apr 8;12(7):651-658. doi: 10.1016/j.jcin.2018.12.029. Epub 2019 Mar 13.

Abstract

Objectives: This study sought to examine depression prevalence among chronic total occlusion (CTO) patients and compared symptom improvement among depressed and nondepressed patients after percutaneous coronary intervention (PCI).

Background: Depression in cardiovascular patients is common, but its prevalence among CTO patients and its association with PCI response is understudied.

Methods: Among 811 patients from the OPEN-CTO (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures) registry, we evaluated change in health status between baseline and 1-year post-PCI, as measured by the Seattle Angina Questionnaire (SAQ) and the Rose Dyspnea Score. Depression was defined using the Personal Health Questionnaire-8. The independent association between health status and depression following PCI was assessed using multivariable regression.

Results: Among the 811 patients, 190 (23%) screened positive for major depression, of whom 6.3% were on antidepressant therapy at intervention. Depressed patients experienced more baseline angina, but by 1-year post-PCI they experienced greater improvements than nondepressed patients (change in SAQ Summary: 31.4 ± 22.4 vs. 24.2 ± 20.0; p < 0.001). After adjustment, baseline depressed patients had more improvement in health status (adjusted difference in SAQ Summary improvement, depressed vs. nondepressed: 5.48 ± 1.81; p = 0.003).

Conclusions: Depression is common among CTO PCI patients, but few were treated with antidepressants at baseline. Depressed patients had more severe baseline angina and significant improvement in health status after PCI. (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion [OPEN-CTO]; NCT02026466).

Keywords: angina; chronic total occlusion; depression; percutaneous coronary intervention.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affect* / drug effects
  • Aged
  • Angina Pectoris / diagnostic imaging
  • Angina Pectoris / epidemiology
  • Angina Pectoris / therapy*
  • Antidepressive Agents / therapeutic use
  • Chronic Disease
  • Coronary Occlusion / diagnostic imaging
  • Coronary Occlusion / epidemiology
  • Coronary Occlusion / therapy*
  • Depression / diagnosis
  • Depression / drug therapy
  • Depression / epidemiology
  • Depression / psychology*
  • Female
  • Health Status
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Percutaneous Coronary Intervention*
  • Prevalence
  • Registries
  • Time Factors
  • Treatment Outcome
  • United States

Substances

  • Antidepressive Agents

Associated data

  • ClinicalTrials.gov/NCT02026466