한빛사논문
- 조회345
Dae Young Cheon1, Yong-Moon Park2,3, Myung Soo Park1, Jae Hyuk Choi1, Mi-Sun Oh4, Seongwoo Han1, Kyung-Ho Yu4, Byung-Chul Lee4, Kyungdo Han5, Minwoo Lee4
1Division of Cardiology, Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hwaseong, South Korea
2Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
3Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
4Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
5Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
Dae Young Cheon and Yong-Moon Park contributed equally.
Corresponding Authors: Kyungdo Han, Minwoo Lee
Abstract
Background
Limited evidence exists on the role of depression in the risk of developing stroke and other cardiovascular outcomes in patients who have undergone percutaneous coronary interventions (PCI). We investigated this relationship with data from the Korean National Health Insurance Service database.
Methods
Our nationwide retrospective cohort study included 164,198 patients who had undergone PCI between 2010 and 2017. Depression was defined with the ICD-10 codes recorded prior to the PCI. The primary outcome was a new-onset stroke following the PCI. Secondary outcomes included PCI with myocardial infarction (MI), revascularization (PCI or coronary artery bypass grafting), and all-cause mortality. A multivariable Cox proportional hazards regression analysis was used to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (CI), adjusting for potential confounders, including sociodemographic and lifestyle factors, comorbidities, and MI at the index PCI.
Results
Over a median follow-up of 5.0 years, acute stroke occurred in 5.7% of patients with pre-existing depression (17.4% of the study population), compared to 3.5% of those without depression. Depression was associated with a 27% increased risk of acute stroke (aHR 1.27, 95% CI 1.20–1.35). Additionally, depression was linked with a 25% elevated risk of all-cause death (aHR 1.25, 95% CI, 1.21–1.29) and an 8% increased risk of revascularization (aHR 1.08, 95% CI 1.04–1.11). The associations with the risk of stroke and all-cause mortality were stronger in patients under 65 years.
Conclusions
Our findings suggest that pre-existing depression may increase the risk of stroke and all-cause mortality following PCI, particularly in patients under 65 years. Additionally, depression was significantly associated with an increased need for revascularization. This underscores the potential benefits of managing depression to reduce stroke risk and overall cardiovascular outcomes following PCI.
논문정보
- Research article
- 2024년 10월 (BRIC 등록일 2024-10-07)
- 국내(교신)+국외 연구진
- 의약학 > 신경의학
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