Patients who undergo angioplasty and stenting to open clogged arteries in and around the heart should also be screened for depression, according to a new study.
Researchers found that depressed patients were less likely than their mentally healthy peers to take their prescribed medications, including beta-blockers, antiplatelets and statins.
These medications reduce the likelihood of another heart attack or cardiovascular event after angioplasty and stenting (also called percutaneous coronary intervention, or PCI).
“It is well-appreciated that depression carries adverse cardiovascular risk. We wanted to understand better why that is the case,” said Dr. Jared Magnani, a cardiologist and associate professor of medicine at the University of Pittsburgh.
“We found that 10% to 20% of individuals with depression were less likely to take their medicine after PCI, which is significant because this group is at a higher risk for serious complications or dying from a heart attack,” he said in a university news release.
Using medical claims data that included prescriptions filled at pharmacies, the researchers examined the records of more than 124,000 patients who had the procedure and were also diagnosed with depression. Patients were followed for a year.
Medication adherence may depend on social factors, such as having the money to cover medication costs, the study authors noted. Pharmacy access is another challenge.
Prior research has found that a high percentage of people with coronary artery disease have or will develop depression. And people with depression have a fourfold increased risk of heart disease.
“This study may help explain why cardiac patients with ... depression tend to have higher rates of hospital readmissions and mortality than non-depressed cardiac patients,” said Dr. Bruce Rollman, professor of medicine at Pitt.
Magnani suggested that incorporating depression screenings into cardiology care could help improve medication adherence and health outcomes for patients with depression.
“We provide critical and sometimes lifesaving therapies to our patients with heart disease, and then prescribe therapies which we know can help them. If depression challenges or reduces their ability to adhere to those medications, then it is essential to address depression as part of cardiovascular care and treatment,” Magnani said.
The findings were published online Dec. 12 in JAMA Network Open. This research was supported by the U.S. National Heart, Lung, and Blood Institute.
The U.S. National Library of Medicine has more on heart procedures.
SOURCE: University of Pittsburgh, news release, Dec. 12, 2022