Depression's Association with Major Adverse Cardiac Events in Patients with Low-Risk Chest Pain.

BACKGROUND

Depression has been identified as an independent risk factor for cardiovascular disease (CVD) development and poor prognosis. However, minimal research on depression's role in CVD has focused on low-risk patients reporting chest pain, a symptom of somatic depression presentation or possible acute coronary syndrome.

OBJECTIVE(S): Thus, our study determined if documented depression was associated with short-term (30 days and 90 days) major adverse cardiac events (MACE) and emergency department (ED) revisit rates.

METHODS

We conducted a retrospective review using abstracted data of 4993 adults who presented to the ED over a 5-year period, complaining of chest pain and deemed low risk by HEART scores <4.

RESULTS

Patients with depression had significantly higher frequencies of 30-day (0.8% vs. 0.2%, p = 0.003) and 90-day MACE (2.1% vs. 0.8%, p < 0.001) compared to patients without depression. In multivariate analysis allowing for the control of confounders, depression (odds ratio [OR] 5.000, confidence interval [CI] 2.614-9.565) and age (OR 1.071, CI 1.047-1.096) predicted 90-day MACE. Rates of ED revisits were higher in patients with depression at 30 days (7.8% vs. 3.3%, p < 0.001) and 90 days (38.8% vs. 19.4%, p < 0.001).

CONCLUSION

Thus, low-risk patients with depression had elevated rates of short-term MACE and ED utilization.