Association between Depression and Clinical Outcomes following Percutaneous Coronary Intervention: A Meta-Analysis

Abstract

<b><i>Background:</i></b> 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. <b><i>Objectives:</i></b> Considering these problems, this meta-analysis was conducted to evaluate the relationship between depression and clinical outcomes after PCI. <b><i>Methods:</i></b> 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. <i>Q</i> test and <i>I</i>² were used to assess heterogeneities between studies. <b><i>Results:</i></b> 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, <i>I</i>² = 57.0%, <i>p</i> = 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, <i>I</i>² = 0.0%, <i>p</i> = 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, <i>I</i>² = 68.9%, <i>p</i> = 0.022). <b><i>Conclusion:</i></b> 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.