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Gender and sex differences in prevalence of major depression in coronary artery disease patients: a meta-analysis.

ABSTRACT: Depression is related to increased morbidity and mortality in the general population and among patients with coronary artery disease (CAD). The prevalence of major depression is two-times higher in women than men in the general population, but whether this pattern holds true in the CAD population has not been established.To test, through quantitative synthesis, whether women with CAD have a greater prevalence of major depression than men.MEDLINE, EMBASE, and PsycINFO electronic databases were searched. Authors of key articles were contacted to identify other relevant publications. The titles and abstracts were screened by the first author and the selected full-text articles were independently screened by the first and second authors based on pre-defined inclusion criteria. Major depression had to be diagnosed through structured clinical interviews during cardiac-related hospitalization or post-CAD hospitalization. Meta-analysis was undertaken using the Review Manager 5 software program. All pooled analyses were based on random-effects models.Eight eligible cohort and cross-sectional studies reporting data for 2072 participants (509 [24.6%] women) were included. Overall, major depression was observed in 95 (18.7%) women and 187 (12.0%) men. In the pooled analysis, prevalence of major depression was significantly greater in women compared to men (odds ratio=1.77, 95% confidence interval=1.21-2.58, p<.01). Heterogeneity was considered low to moderate (I(2)=36.0%).Consistent with the general population, the prevalence of major depression is two-times greater in women than men with CAD. Women with CAD may warrant greater emphasis in efforts to identify and treat depression.

SUBMITTER: Shanmugasegaram S

PROVIDER: S-EPMC4490896 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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Gender and sex differences in prevalence of major depression in coronary artery disease patients: a meta-analysis.

Shanmugasegaram Shamila S Russell Kelly L KL Kovacs Adrienne H AH Stewart Donna E DE Grace Sherry L SL

Maturitas 20120928 4

<h4>Background</h4>Depression is related to increased morbidity and mortality in the general population and among patients with coronary artery disease (CAD). The prevalence of major depression is two-times higher in women than men in the general population, but whether this pattern holds true in the CAD population has not been established.<h4>Objective</h4>To test, through quantitative synthesis, whether women with CAD have a greater prevalence of major depression than men.<h4>Method</h4>MEDLIN ...[more]

PMID: 23026020

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Project description:In comparison to male patients with coronary artery disease, female patients suffer from more comorbidities, experience symptoms of coronary artery disease differently and report poorer health-related quality of life (HRQoL) after coronary revascularization. However, there is limited data on the impact of comorbidity burden on the recovery in HRQoL in female and male patients. We investigated the impact of comorbidity burden on the change in HRQoL following coronary revascularization in female patients versus male patients. 230 patients (60 female) with coronary artery disease were assessed before, and two weeks, three months and six months after coronary revascularization. Disease-specific HRQoL was measured with the Short-Form Seattle Angina Questionnaire. Physical and mental health was measured with the Short-Form Health Survey. Comorbidity burden was assessed by the total number of identified comorbidity conditions and by the Charlson comorbidity score. Linear mixed models were used to estimate the effects of time, gender and comorbidity burden on HRQoL. Whereas HRQoL improved after coronary revascularization in all patients, female patients reported poorer physical health and disease-specific HRQoL and their physical health improved more slowly than male patients. A higher comorbidity burden was related with poorer physical health and disease-specific HRQoL in male patients, but not in female patients. A higher comorbidity burden was associated with slower improvement in HRQoL for both female and male patients. Female patients reported poorer HRQoL and their physical health improved more slowly after coronary revascularization, irrespective of comorbidity burden. Higher comorbidity burden was associated with poorer physical health and disease-specific HRQoL in male patients only. Our results indicate that female and male patients recover differently after coronary revascularization. These findings highlight the importance of comorbidity- and gender-specific approaches for evaluating coronary artery disease and coronary revascularization procedures.

Project description:Background It is still unknown whether traditional risk factors may have a sex-specific impact on coronary artery disease (CAD) burden. Methods and Results We identified 14 793 patients who underwent coronary angiography for acute coronary syndromes in the ISACS-TC (International Survey of Acute Coronary Syndromes in Transitional Countries; ClinicalTrials.gov, NCT01218776) registry from 2010 to 2019. The main outcome measure was the association between traditional risk factors and severity of CAD and its relationship with 30-day mortality. Relative risk (RR) ratios and 95% CIs were calculated from the ratio of the absolute risks of women versus men using inverse probability of weighting. Estimates were compared by test of interaction on the log scale. Severity of CAD was categorized as obstructive (≥50% stenosis) versus nonobstructive CAD. The RR ratio for obstructive CAD in women versus men among people without diabetes mellitus was 0.49 (95% CI, 0.41-0.60) and among those with diabetes mellitus was 0.89 (95% CI, 0.62-1.29), with an interaction by diabetes mellitus status of P =0.002. Exposure to smoking shifted the RR ratios from 0.50 (95% CI, 0.41-0.61) in nonsmokers to 0.75 (95% CI, 0.54-1.03) in current smokers, with an interaction by smoking status of P=0.018. There were no significant sex-related interactions with hypercholesterolemia and hypertension. Women with obstructive CAD had higher 30-day mortality rates than men (RR, 1.75; 95% CI, 1.48-2.07). No sex differences in mortality were observed in patients with nonobstructive CAD. Conclusions Obstructive CAD in women signifies a higher risk for mortality compared with men. Current smoking and diabetes mellitus disproportionally increase the risk of obstructive CAD in women. Achieving the goal of improving cardiovascular health in women still requires intensive efforts toward further implementation of lifestyle and treatment interventions. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01218776.

Dataset Information

Gender and sex differences in prevalence of major depression in coronary artery disease patients: a meta-analysis.

Publications

Gender and sex differences in prevalence of major depression in coronary artery disease patients: a meta-analysis.

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