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Psychosocial and medical predictors of 14-year mortality and morbidity in male and female coronary artery bypass graft recipients: a prospective observational study

Published online by Cambridge University Press:  11 February 2021

Wolfgang Linden ,
Sandra Young ,
Andrew Ignaszewski  and
Tavis Campbell
Wolfgang Linden*
Affiliation:
Department of Psychology, University of British Columbia, Vancouver, Canada
Sandra Young
Affiliation:
Department of Psychology, University of British Columbia, Vancouver, Canada Department of Psychology, University of Calgary, Vancouver, Canada
Andrew Ignaszewski
Affiliation:
Division of Cardiology, St Paul's Hospital and University of British Columbia, Vancouver, Canada
Tavis Campbell
Affiliation:
Department of Psychology, University of Calgary, Vancouver, Canada
*
Author for correspondence: Wolfgang Linden, E-mail: wlinden@psych.ubc.ca
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Abstract

Background

Psychosocial factors may influence mortality and morbidity after coronary bypass surgery (CABG), but it is unclear when, post-surgery, they best predict the outcome, if they interact, or whether results differ for men and women.

Methods

This prospective, observational study assessed depression symptoms, social support, marital status, household responsibility, functional impairment, mortality and need for further coronary procedures over 14 years of follow-up. Data were collected in-hospital post-CABG and at home 1-year later. Mortality and subsequent cardiac procedure data were extracted from a Cardiac Registry.

Results

Of 296 baseline participants, 78% (43% were women) completed data at 1-year post-CABG. Long-term survival was shorter with 1-year depression and lower household responsibility but that was not true for the measures taken at baseline [HR for depression = 1.27; 95% CI 1.02–1.59 v. 0.99 (0.78–1.25), and HR = 0.71; 95% CI 0.52–0.97 v. 0.97 (0.80–1.16)] for household responsibility. An interaction between depression symptoms and social support at year 1 [χ2 (11) = 111.05, p < 0.001] revealed a greater hazard of mortality d with increased depression only at mean (HR = 1.67; 95% CI 1.21–2.26) and high social support (HR = 2.23; 95% CI 1.46–3.40). Depression also accounted for increased event recurrence. There were no significant interactions of sex with medical long-term outcomes.

Conclusions

In a sex-balanced sample, depression and household responsibility measured at 1-year post-CABG were associated with significant variance in unadjusted and adjusted predictor models of long-term mortality whereas the same indices determined right after the procedure were not significant predictors.

Keywords

coronary artery bypass graftcoronary artery diseasemorbiditymortalitypsychosocial functioning
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 15 , November 2022 , pp. 3460 - 3471
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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