Depressive symptoms and mortality two years after coronary artery bypass graft surgery (CABG) in men.

OBJECTIVES: Depression has been related to mortality in patients with CAD and to medical morbidity after CABG; however, prior studies have not examined the contribution of presurgical depressive symptoms to mortality after CABG. The purpose of this study was to determine the independent contribution of presurgical symptoms of depression to 2-year cardiac mortality after CABG.

METHODS: Eighty-nine consecutive veteran nonemergent CABG patients recruited between December 1996 and June 1998 completed the BDI 1 to 7 days before surgery. Mortality risk was assessed by medical co-morbidity and RIS.

RESULTS: Significant univariate contributions to two-year cardiovascular mortality were found for RIS (chi2 = 6.57, p <.01), history of CHF (chi2 = 4.94, p <.02), history of COPD (chi2 = 5.19, p <.02), and elevated depressive symptoms (chi2 = 4.70, p <.03). The multivariate model revealed that the RIS (chi2 = 4.70, p <.03) and elevated depressive symptoms (chi2 = 3.86, p <.05) remained significant in the prediction of 2-year cardiovascular mortality, with no other variables being found significant.

CONCLUSIONS: Elevated depressive symptoms before CABG surgery appear to be an important independent contributor to long-term mortality. Future research should focus on replication with larger, more diverse samples, and identification of pathophysiological mechanisms.