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Antilipidemic adherence post-coronary artery disease diagnosis among those with and without an ICD-9 diagnosis of depression.
J Psychosom Res. 2010 Aug; 69(2):169-74.JP

Abstract

OBJECTIVES

An association between depression and coronary artery disease (CAD) is well established. Poor adherence to cardiac treatments may be one way depression could contribute to the increased risk of coronary events among depressed patients. We sought to evaluate whether adherence to antilipid medication, a therapy shown to be beneficial in secondary prevention of coronary events, differs among CAD patients with and without an ICD-9 depression diagnosis.

METHODS

Patients were included if, at angiography, they were determined to have CAD (stenosis >or=70%), were discharged on an antilipid medication, and re-filled their prescriptions at a participating pharmacy. A patient was determined to have depression (ICD-9 codes 296.2-296.36, 311) if the diagnosis occurred prior to angiography or within 6 months of the CAD diagnosis. Adherence and long-term outcomes were evaluated at 6 months, 1 year, 18 months and 2 years.

RESULTS

A total of 585 patients were included, with 73 (12.5%) having a diagnosis of depression prior to or within 6 months of CAD diagnosis. At all time-points, those with depression had a lower mean adherence compared to those without depression. Differences in adherence rates after adjustment were 7% (P=.001), 6% (P=.02), 13% (P<.0001) and 5% (P=.18) at 6 months, 1 year, 18 months, and 2 years, respectively. Though not statistically significant, there were clinically important associations between adherence and depression on the combined outcome of death, myocardial infarction, and revascularization.

CONCLUSION

Depression was the strongest predictor of antilipidemic medication adherence after 2 years of follow-up among CAD patients. Such results suggest that poor antilipid adherence may be one mechanism by which depression contributes to CAD events.

Authors+Show Affiliations

Intermountain Medical Center, Murray, UT 84157, USA. heidi.may@imail.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20624515

Citation

May, Heidi T., et al. "Antilipidemic Adherence Post-coronary Artery Disease Diagnosis Among Those With and Without an ICD-9 Diagnosis of Depression." Journal of Psychosomatic Research, vol. 69, no. 2, 2010, pp. 169-74.
May HT, Sheng X, Catinella AP, et al. Antilipidemic adherence post-coronary artery disease diagnosis among those with and without an ICD-9 diagnosis of depression. J Psychosom Res. 2010;69(2):169-74.
May, H. T., Sheng, X., Catinella, A. P., Horne, B. D., Carlquist, J. F., & Joy, E. (2010). Antilipidemic adherence post-coronary artery disease diagnosis among those with and without an ICD-9 diagnosis of depression. Journal of Psychosomatic Research, 69(2), 169-74. https://doi.org/10.1016/j.jpsychores.2010.01.026
May HT, et al. Antilipidemic Adherence Post-coronary Artery Disease Diagnosis Among Those With and Without an ICD-9 Diagnosis of Depression. J Psychosom Res. 2010;69(2):169-74. PubMed PMID: 20624515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antilipidemic adherence post-coronary artery disease diagnosis among those with and without an ICD-9 diagnosis of depression. AU - May,Heidi T, AU - Sheng,Xiaoming, AU - Catinella,A Peter, AU - Horne,Benjamin D, AU - Carlquist,John F, AU - Joy,Elizabeth, Y1 - 2010/03/17/ PY - 2009/07/01/received PY - 2010/01/15/revised PY - 2010/01/29/accepted PY - 2010/7/14/entrez PY - 2010/7/14/pubmed PY - 2010/10/30/medline SP - 169 EP - 74 JF - Journal of psychosomatic research JO - J Psychosom Res VL - 69 IS - 2 N2 - OBJECTIVES: An association between depression and coronary artery disease (CAD) is well established. Poor adherence to cardiac treatments may be one way depression could contribute to the increased risk of coronary events among depressed patients. We sought to evaluate whether adherence to antilipid medication, a therapy shown to be beneficial in secondary prevention of coronary events, differs among CAD patients with and without an ICD-9 depression diagnosis. METHODS: Patients were included if, at angiography, they were determined to have CAD (stenosis >or=70%), were discharged on an antilipid medication, and re-filled their prescriptions at a participating pharmacy. A patient was determined to have depression (ICD-9 codes 296.2-296.36, 311) if the diagnosis occurred prior to angiography or within 6 months of the CAD diagnosis. Adherence and long-term outcomes were evaluated at 6 months, 1 year, 18 months and 2 years. RESULTS: A total of 585 patients were included, with 73 (12.5%) having a diagnosis of depression prior to or within 6 months of CAD diagnosis. At all time-points, those with depression had a lower mean adherence compared to those without depression. Differences in adherence rates after adjustment were 7% (P=.001), 6% (P=.02), 13% (P<.0001) and 5% (P=.18) at 6 months, 1 year, 18 months, and 2 years, respectively. Though not statistically significant, there were clinically important associations between adherence and depression on the combined outcome of death, myocardial infarction, and revascularization. CONCLUSION: Depression was the strongest predictor of antilipidemic medication adherence after 2 years of follow-up among CAD patients. Such results suggest that poor antilipid adherence may be one mechanism by which depression contributes to CAD events. SN - 1879-1360 UR - https://www.unboundmedicine.com/medline/citation/20624515/Antilipidemic_adherence_post_coronary_artery_disease_diagnosis_among_those_with_and_without_an_ICD_9_diagnosis_of_depression_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3999(10)00071-1 DB - PRIME DP - Unbound Medicine ER -