Psychological Correlates of Outcome after Coronary Artery Bypass Graft

Sharma, Shaina; Pawar, AA; Kumar, B; Srivastava, Kalpana; Sudarsanan, S; Singh, Dharmender

doi:10.1016/s0377-1237(06)80004-3

Cited by 12 publications

(9 citation statements)

References 26 publications

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“…The association between depression and poor outcomes in cardiovascular disease is well established. 3,11,45 Cardiovascular disease contributes to depression according to the vascular-depression hypothesis that thromboembolism and hypotension from vascular disease reduce perfusion to brain areas associated with depression—in particular, the frontal-subcortical circuits and hippocampus.…”

Section: Discussionmentioning

confidence: 99%

Depressive Symptoms After CABG Surgery

Ravven

Bader²,

Azar³

et al. 2013

Harvard Review of Psychiatry

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Objective Depression is highly comorbid with coronary artery disease. Clinicians face the question of whether patients’ depressive symptoms will improve after coronary artery bypass graft surgery (CABG). The objective of this meta-analysis is to determine the course of depressive symptoms after CABG. Methods EMBASE, PubMed, and PsycINFO were searched for studies assessing depression before and after CABG. Meta-analyses were performed for depression at early (1–2 weeks), recovery (>2 weeks to 2 months), mid (>2 months to 6 months), and late (>6 months) postoperative time points. Heterogeneity and publication bias were analyzed. Results Thirty-nine studies were included in the meta-analysis. Twelve reported dichotomous outcomes; 18 reported continuous outcomes; and 9 reported both. Risk of depression was increased early (relative risk [RR] = 1.27; 95% confidence interval [CI], 1.01–1.61). There was a significantly decreased risk of depression at recovery (RR = 0.78; 95% CI, 0.67–0.90), mid (RR = 0.64; 95% CI, 0.58–0.70), and late (RR = 0.68; 95% CI, 0.58–0.79) time points without heterogeneity. All studies reporting continuous depression scales had significant heterogeneity. Conclusions The risk of depression decreased post-CABG when depression was measured dichotomously. While depression improves overall and remits for some patients after CABG, the majority of patients will not experience remission of depression. Preoperative and postoperative depression monitoring is important.

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Section: Discussionmentioning

confidence: 99%

Depressive Symptoms After CABG Surgery

Ravven

Bader²,

Azar³

et al. 2013

Harvard Review of Psychiatry

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“…[ 44 ] Better QOL after CABG reduce the chance of depression. [ 45 ] Anxiety has much influence on cardiac adverse events than distress after 5 years of CABG. [ 2 ]…”

Section: Discussionmentioning

confidence: 99%

“…Depression reduced with lifestyle program after 1 year in CHD patients with or without diabetes mellitus. [ 45 ] Depression but not anxiety is associated with the number of hospitalizations, hospital stay, and all-cause mortality in ischemic heart disease. [ 46 ] In CHD, the chance of HADS-D score is more and it will be much with the presence of risk factors like systolic blood pressure and body mass index.…”

Section: Discussionmentioning

confidence: 99%

Yoga-Based Postoperative Cardiac Rehabilitation Program for Improving Quality of Life and Stress Levels

Eraballi

Ramarao

Nagarathna

et al. 2018

International Journal of Yoga

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Objectives: This study was aimed to assess the efficacy of yoga-based lifestyle program (YLSP) in improving quality of life (QOL) and stress levels in patients after 5 years of coronary artery bypass graft (CABG). Methodology: Three hundred patients posted for elective CABG in Narayana Hrudayalaya Super Speciality Hospital, Bengaluru, were randomized into two groups: YLSP and conventional lifestyle program (CLSP), and follow-up was done for 5 years. Intervention: In YLSP group, all practices of integrative approach of yoga therapy such as yama, niyama, asana, pranayama, and meditation were used as an add-on to conventional cardiac rehabilitation. The control group (CLSP) continued conventional cardiac rehabilitation only. Outcome Measures: World Health Organization (WHO)-QOL BREF Questionnaire, Perceived Stress Scale, Positive and Negative Affect Scale (PANAS), and Hospital Anxiety and Depression Scale (HADS) were assessed before surgery and at the end of the 5th year after CABG. As data were not normally distributed, Mann–Whitney U-test was used for between-group comparisons and Wilcoxon's signed-rank test was used for within-group comparisons. Results: At the end of 5 years, mental health (P = 0.05), perceived stress (P = 0.01), and negative affect (NA) (P = 0.05) have shown significant improvements. WHO-QOL BREF score has shown improvements in physical health (P = 0.046), environmental health (P = 0.04), perceived stress (P = 0.001), and NA (P = 0.02) in YLSP than CLSP. Positive affect has significantly improved in CLSP than YLSP. Other domains of WHO-QOL-BREF, PANAS, and HADS did not reveal any significant between-group differences. Conclusion: Addition of long-term YLSP to conventional cardiac rehabilitation brings better improvements in QOL and reduction in stress levels at the end of 5 years after CABG.

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“…[ 5 ] As per a systematic review with meta-analysis, variables like psychological (stressful life events, emotional distress and personality) factors should be examined to predict the progression of disease and QOL after CABG. [ 34 ] Depression and anxiety are cardiac risk factors are less but continue to be sustained even after 7 days,[ 35 ] 10 days[ 36 ] and after 5 years[ 37 ] of CABG. Psychosomatic symptoms, especially anxiety, may be associated with irregularity in circadian rhythm, which can be altered by basic lifestyle habits in healthy volunteers.…”

Section: Psychological Healthmentioning

confidence: 99%

Quality of life improvement with rehabilitation according to constitution of the World Health Organization for coronary artery bypass graft surgery patients: A descriptive review

Eraballi

Pradhan

2017

AYU

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This is a descriptive review focusing on trends of treatments required for postoperative coronary artery bypass graft surgery (CABG) patients to improve the quality of life (QOL).Methodology:The sources of literary research to understand the concepts of coronary artery disease according to Indian scriptures are Ayurveda texts, Bhagavad Gita, Patanjali Yoga Sutra. The data was typed in Sanskrit using Devanagari script and explanation in English was given. As per new research techniques, surgery, physiotherapy rehabilitation and Yoga are serving CABG patient's medical and psychological health better. The World Health Organization (WHO) defines health as physical, mental and social well-being later redefined with additional terms like environmental and spiritual health. This definition is similar to the Panchakosha concept in Yoga and Pancha Mahabhutas in Ayurveda. In cases of emergency or passive treatment, medication serves as a better option for physical health. In circumstances where the person is able to move in daily activities (just after discharge), rehabilitation serves as a better option for physical, mental and social health. Travel and reactions to climatic change serve environmental health. Last strategy, belief, cultural and traditional methods with scientific background serves as the spiritual health. These step-wise treatments are required for CABG patients to get the overall health or QOL. However, surgery and physiotherapy rehabilitation are advanced as per modern era which serves physical, mental, and social health also, but environmental health and spiritual health have yet to be addressed. As an ancient system of medicine, Yoga combines physical, mental, social, environmental and spiritual practices and it should be added as treatment along with surgery and physiotherapy rehabilitation. If all of these therapies were in the treatment protocol for CABG surgery patients, we would observe the changes of QOL and fulfill the requirements of constitution of the WHO. Integrating concepts of Yoga, Ayurveda, modern rehabilitation, surgery and patient cooperation with lifestyle change are the key to QOL improvements after CABG.

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Psychological Correlates of Outcome after Coronary Artery Bypass Graft

Abstract: There is a significant incidence of anxiety and depression in patients undergoing CABG, both before and after surgery.

Cited by 12 publications

References 26 publications

Depressive Symptoms After CABG Surgery

Depressive Symptoms After CABG Surgery

Yoga-Based Postoperative Cardiac Rehabilitation Program for Improving Quality of Life and Stress Levels

Quality of life improvement with rehabilitation according to constitution of the World Health Organization for coronary artery bypass graft surgery patients: A descriptive review

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