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New Postoperative Depressive Symptoms and Long-Term Cardiac Outcomes After Coronary Artery Bypass Surgery

Received July 15, 1999; revised January 10, May 16, August 16, October 3, October 19, 2000; accepted November 22, 2000. From the CCABOT (Cornell Coronary Artery Bypass Outcomes Trial) Group, Departments of Medicine, Cardiothoracic Surgery, and Psychiatry, Weill Medical College, Cornell University, New York, NY. Address correspondence to Ms. Janey Peterson, R.N., M.A., Director of Clinical Research, The Center for Complementary and Integrative Medicine and The Division of General Internal Medicine, Cornell University, Weill Medical College, 525 E. 68th St., Box 46, New York, NY 10021.

The authors evaluated the impact of an increase in depressive symptoms at 6 months after elective coronary artery bypass graft surgery on long-term cardiac morbidity and mortality between 6 and 36 months postoperatively. Patients who had low scores for depressive symptomatology pre-operatively and who completed follow-up at 6 months were contacted again 36 months after surgery to assess cardiac and neurologic morbidity and mortality. At 36 months after surgery, an interval history was completed, and baseline questionnaires were readministered. Follow-up was obtained on 123/124 patients (99%). The rate of combined new cardiac morbidity/mortality between 6 and 36 months was 13.6% among those with newly increased depressive symptoms at 6 months vs. 3.0% in the patients without new depressive symptoms at 6 months. Only an increase in depressive symptoms at 6 months was related to the occurrence of subsequent cardiac complications between 6 and 36 months. In this small sample of patients, increased depressive symptoms at 6 months after surgery appear to be associated with the occurrence of subsequent major cardiac morbidity/ mortality.

Key Words: Postoperative Depression • Outcome Studies • Comorbidity

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