Author + information
- Received September 17, 2018
- Revision received December 18, 2018
- Accepted December 26, 2018
- Published online April 1, 2019.
- Robert W. Yeh, MD, MSca,∗ (, )
- Hector Tamez, MD, MPHa,
- Eric A. Secemsky, MD, MSca,
- J. Aaron Grantham, MDb,
- James Sapontis, MBBChc,
- John A. Spertus, MD, MPHb,
- David J. Cohen, MD, MScb,
- William J. Nicholson, MDd,
- Kensey Gosch, MSb,
- Philip G. Jones, MSb,
- Linda R. Valsdottir, MSa,
- Jeffrey Bruckel, MD, MPHe,
- William L. Lombardi, MDf and
- Farouc A. Jaffer, MD, PhDg
- aRichard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- bSaint Luke’s Mid America Heart Institute/UMKC, Kansas City, Missouri
- cMonashHeart, Melbourne, Victoria, Australia
- dYork Hospital, York, Pennsylvania
- eDivision of Cardiology, University of Rochester, Rochester, New York
- fDivision of Cardiology, University of Washington, Seattle, Washington
- gDivision of Cardiology, Massachusetts General Hospital, Boston, Massachusetts
- ↵∗Address for correspondence:
Dr. Robert W. Yeh, Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, 375 Longwood Avenue, 4th floor, Boston, Massachusetts 02215.
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)
This study was an investigator-initiated registry funded by Boston Scientific. Dr. Yeh has received research grant support from Abiomed, AstraZeneca, and Boston Scientific; has Scientific Advisory Board membership for Abbott Vascular, Boston Scientific, and Medtronic; and received consulting honoraria from Abbott Vascular, Asahi Intecc, Boston Scientific, and Teleflex. Dr. Grantham has received speaking fees and honoraria from Boston Scientific, Abbott Vascular, and Asahi Intecc; has received institutional research grant support from Boston Scientific; institutional educational grant support from Abbott Vascular, Vascular Solutions, Boston Scientific, and Asahi Intecc; and is a part-time employee of Corindus Vascular Robotics. Dr. Sapontis has received speaking fees and honoraria from Boston Scientific. Dr. Spertus has received research grants from Lilly, Novartis, and Abbott Vascular; served as a consultant for Novartis, Amgen, Bayer, and United Healthcare; owns the copyright to the Seattle Angina Questionnaire; and has an equity interest in Health Outcomes Sciences. Dr. Cohen has received institutional research grant support from Boston Scientific, Abbott Vascular, and Medtronic; and consulting fees from Medtronic. Dr. Nicholson has performed consulting/proctoring for Abbott Vascular, Boston Scientific, and Medtronic; and is on the Advisory Board of Abbott Vascular, Boston Scientific, and Medtronic. Dr. Bruckel has a consulting role with AvantGarde Health. Dr. Lombardi has received speaking fees and honoraria from Boston Scientific, Abbott Vascular, and Abiomed; consulted for Vascular Solutions, Abbott Vascular, Boston Scientific, Abiomed, and Roxwood Medical; has equity in Roxwood Medical and Bridgepoint Medical; and his wife is an employee of Spectranetics. Dr. Jaffer has received consulting fees from Abbott Vascular, Boston Scientific, Philips, and Siemens; and research grant funding from Siemens and Canon. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 17, 2018.
- Revision received December 18, 2018.
- Accepted December 26, 2018.
- 2019 American College of Cardiology Foundation
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