1
|
Zhang Y, Zhai Y, Niu B, Liu X, Zhang X, Wu S, Zhu C. Association between Depression and Clinical Outcomes following Percutaneous Coronary Intervention: A Meta-Analysis. Psychopathology 2022; 55:251-257. [PMID: 35421863 DOI: 10.1159/000524228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/19/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several studies suggested that depression was associated with poor prognosis following percutaneous coronary intervention (PCI) in coronary heart disease (CHD), whereas other studies showed that there were no associations between depression and poor outcomes. OBJECTIVES Considering these problems, this meta-analysis was conducted to evaluate the relationship between depression and clinical outcomes after PCI. METHODS Articles published before July 2021 were analyzed from the databases: PubMed, Web of Science, EMBASE, Medline, and Google Scholar. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed to generate a pooled effect size and 95% CI with a random or fixed effects model. Q test and I2 were used to assess heterogeneities between studies. RESULTS The meta-analysis indicated that depression was associated with a higher risk of major adverse cardiac events (MACE) after PCI with a random effects model (HR = 1.89, 95% CI: 1.33-2.68, I2 = 57.0%, p = 0.023). The study indicated that depression was associated with a higher risk of all-cause mortality after PCI with a fixed effects model (HR = 1.71, 95% CI: 1.43-2.05, I2 = 0.0%, p = 0.756). The study indicated no significant association between depression and risk of repeat revascularization after PCI with a random effects model (HR = 2.10, 95% CI: 0.96-4.58, I2 = 68.9%, p = 0.022). CONCLUSION Results indicated that depression is associated with adverse clinical outcomes in CHD patients' post-PCI. Appropriate mental health check and psychological treatment may be necessary for the prognosis of CHD patients who receive PCI.
Collapse
Affiliation(s)
- Yifan Zhang
- First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China
| | - You Zhai
- First Affiliated Hospital, Henan University of Chinese Medicine, Zhengzhou, China
| | - Bohan Niu
- Evidence-based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaolu Liu
- First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiaoxiao Zhang
- First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shangwen Wu
- First Affiliated Hospital, Henan University of Chinese Medicine, Zhengzhou, China
| | - Cuiling Zhu
- First Affiliated Hospital, Henan University of Chinese Medicine, Zhengzhou, China
| |
Collapse
|
2
|
Song X, Song J, Shao M, Gao X, Ji F, Tian H, Xu Y, Zhuo C. Depression predicts the risk of adverse events after percutaneous coronary intervention: A meta-analysis. J Affect Disord 2020; 266:158-164. [PMID: 32056871 DOI: 10.1016/j.jad.2020.01.136] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/21/2019] [Accepted: 01/25/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Depression is correlated with poor prognosis in patients with coronary artery disease (CAD). The goal of this meta-analysis was to assess the influence of depression on the risks of major adverse cardiovascular events (MACEs) and all-cause mortality after percutaneous coronary intervention (PCI). METHODS Cohort studies were obtained by searching PubMed and Embase databases. Cohort studies regarding the association between depression and risks of MACEs and mortality after PCI were included. Heterogeneity was determined using the Cochrane's Q test and calculated using I2. A fixed-effect model was used if no significant heterogeneity was detected; otherwise a random-effect model was applied. The adjusted risk ratio [RR] for the incidences of MACEs and all-cause mortality in patients with depression were compared to those without depression. RESULTS Nine cohorts including 4,555 CAD patients who underwent PCI were included in this meta-analysis, and 1,108 of these patients were diagnosed with depression. There were no significant differences among studies evaluating MACEs and mortality risks (I2 = 25% and 0%, respectively). Pooled results showed that depression was associated with higher risk of MACEs (RR: 2.10, 95% confidence interval [CI]: 1.59 to 2.77, p < 0.001) and all-cause mortality (RR: 1.76, 95% CI: 1.45 to 2.13, p < 0.001) during follow-up after PCI. LIMITATIONS Available full text peer reviewed studies were limited and only studies in English were included in this analysis. CONCLUSIONS Depressive symptoms were independently associated with adverse cardiovascular outcomes in patients who received PCI. Psychological therapy that does not increase cardiac burden or induce pharmacological side effects may be a better strategy to treat depression associated with PCI.
Collapse
Affiliation(s)
- Xueqin Song
- The First Affiliated Hospital Zhengzhou University, Biological Psychiatry International Joint Laboratory of Henan/Zhengzhou University, Henan Psychiatric Transformation Research Key Laboratory/Zhengzhou University, Zhengzhou, 450052, China
| | - Junxian Song
- Department of Cardiology, Peking University people's Hospital, Beijing, 100201, China
| | - Mingjing Shao
- Department of Cardiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Xiangyang Gao
- Health Management Institute, Center for Statistical Analysis of Medical Data, Medical Big Data Analysis Center, Chinese PLA General Hospital, Beijing, 100191, China
| | - Feng Ji
- School of Mental Health, Jining Medical University, Jining, 272119, Shandong Province, China
| | - Hongjun Tian
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, School of Basic Medical Research, Tianjin Medical University, Tianjin, 300075, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China, MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, China
| | - Chuanjun Zhuo
- The First Affiliated Hospital Zhengzhou University, Biological Psychiatry International Joint Laboratory of Henan/Zhengzhou University, Henan Psychiatric Transformation Research Key Laboratory/Zhengzhou University, Zhengzhou, 450052, China; School of Mental Health, Jining Medical University, Jining, 272119, Shandong Province, China; Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, School of Basic Medical Research, Tianjin Medical University, Tianjin, 300075, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China, MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
| |
Collapse
|
3
|
Oral Chinese Herbal Medicine for Depressive Disorder in Patients after Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis. Chin J Integr Med 2019; 26:617-623. [PMID: 31222629 DOI: 10.1007/s11655-019-2702-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the effectiveness and safety of oral Chinese herbal medicines (CHMs) on post-percutaneous coronary intervention (PCI) patients with depressive disorder in coronary heart disease (CHD). METHODS A literature search was conducted through databases including PubMed, Cochrane Library, Chinese National Knowledge Infrastructure Databases (CNKI), Chinese Biomedical Literature Database (SinoMed), Chongqing VIP Chinese Science and Technology Periodical Database (VIP) and Wanfang Database up to August 2018. Randomized controlled trials (RCTs) comparing CHMs with placebo or no additional treatments on the basis of standard conventional pharmacological therapies were included. Data extraction, analyses and quality assessment were performed according to the Cochrane standards. RevMan 5.3 software was used to synthesize the results. RESULTS A total of 16 RCTs enrolling 1,443 participants were included in this systematic review. When compared with antidepressants alone, CHMs showed similar benefits with less side effects [risk ratio=0.54, 95% confidence interval (CI) 0.43 to 0.69, 582 patients]; meanwhile, the combination therapy may have more advantages than antidepressants alone [mean difference (MD)=-1.03, 95%CI-1.81 to-0.25, 267 patients). When identified with placebo, CHMs seem to have more advantages in relieving depressive symptoms (MD=-19.00, 95%CI-20.02 to-17.98, 189 patients). However, when compared with basic treatment of post- PCI, CHMs showed different results in two trials. In terms of post-PCI related clinical symptoms, CHMs seem to have more advantages in relieving chest pain and other general clinical symptoms. However, the heterogeneity in this review was generally high, it may be caused by different interventions used in each trial and the low quality of the trials. CONCLUSIONS In total, CHMs showed potentially beneficial effects on depressive symptoms and post-PCI related clinical symptoms. However, because of small sample size and potential bias of most trials, this result should be interpreted with caution. More rigorous trials with larger sample size and higher quality are warranted to give high quality of evidence to support the use of CHMs for CHD complicated with depression.
Collapse
|