Postoperative depression in patients after coronary artery bypass grafting (CABG) – a review of the literature

Abstract

<b>Introduction:</b> Ischemic heart disease is the most common cause of death in the world. The lives of patients with vascular defects can be saved by coronary artery bypass grafting (CABG). However, it is associated with an increased risk of developing depression after surgery. <br><b>Meterial and Methods:</b> The aim of the study is to present the results of the latest research on postoperative depression after CABG, including studies describing the course of the disease, its consequences for the patient’s prognosis and treatment. The publications available on the PubMed platform published after 2011 were reviewed. <br><b>Results:</b> Depression before and after CABG affects 30–40% of patients, mostly women. Established after surgery and untreated, it persists for many years. The level of anxiety in patients decreases systematically after surgery. Indicators that may correlate with the patient’s postoperative depression, including cortisol, high sensitivity C-reactive protein (hsCRP) and oxidative stress biomarkers, are being investigated. The occurrence of depression in patients after CABG has a number of negative consequences. Those include: weaker response to treatment, greater chance of relapse, and increased readmission frequency and mortality. Treatment of patients with this disorder involves the use of antidepressants (most often SSRIs – selective serotonin reuptake inhibitor) and/or various types of psychotherapy with cognitive behavioral therapy (CBT) at the forefront. <br><b>Conclusions:</b> Depression following CABG decreases the quality of life and worsens patient prognosis. It is necessary to detect this condition early after surgery and to apply treatment, taking into account the cardiological disorders of the patient.

Applying Machine Learning to Construct a Model of Risk of Depression in Patients Following Cardiac Surgery with the Use of the SF-12 Survey

“…In the current study, an a priori risk of depression was observed in 29.03% of patients. A literature review indicated that the prevalence of depression after cardiac surgery is between 15% and 40%, and symptoms of depression can be identified in up to 60% [ 2 , 3 , 4 , 28 , 29 ]. Thus, our results are in line with those of other authors.…”

“…The prevalence of depression in this particular group of patients varies between studies and ranges from 13% to 40% of patients. In some patients, it may be a long-term problem, becoming a chronic condition [ 2 , 3 , 4 ]. The increasing number of cardiac surgeries worldwide is leading to a large group of people suffering from depression after cardiac surgery.…”

“…Apart from the psychological suffering and decreased function of these patients, depression also increases the risk of rehospitalization, morbidity, and mortality [ 4 , 5 , 6 ]. Screening for depression is recommended by the American Heart Association (AHA) and the American Psychiatrists Association (APA) [ 7 ] both pre- and post-operatively [ 2 , 4 , 8 ]. Identifying patients at risk of depression is vital for implementing early interventions [ 3 ].…”

“…Identifying patients at risk of depression is vital for implementing early interventions [ 3 ]. Considering the higher probability of depression post-operatively, mental health monitoring following surgery seems to be essential [ 2 , 3 , 4 ]. Screening is a first crucial step in identifying mental health problems.…”

Therapeutic Efficacy of a Staged Hybrid Technique vs. Coronary Artery Bypass Surgery Grafting in The Treatment of Multi-Vessel Coronary Artery Disease

“…The HCR integrates bridging between the left internal mammary artery and the anterior descending artery with PCI of other vessels and can provide effective treatment for different types of CAD. Traditional CABG gradually has been replaced in the last decade, and previous studies have found that dangerous events, such as depression [Stanicki 2020], stroke [Newman 2001;Tarakji 2011], and delirium [Martin 2012] occur after CABG, which not only decreases the quality of life but also worsens the prognosis of patients. Moreover, some patients have concomitant diseases in clinical practice, such as diabetes mellitus, chronic obstructive pulmonary disease, ascending aortic disease, peripheral vascular disease, and malignancies.…”