Abstract 4140268: Outcomes of Percutaneous Coronary Intervention in Patients With Major Depressive Disorder

Introduction: Cardiac catheterization with percutaneous coronary intervention (PCI) has been the cornerstone of treatment in patients who present with myocardial infarction. Different outcomes have been studied in different patient populations. However, it is unclear if patients with major depressive disorder (MDD) have been receiving the appropriate treatment, or if patients with MDD who undergo PCI have different outcomes compared to the general population. Methods: Sample size was obtained from the National Inpatient Sample (NIS) from 2016 to 2019. We found 1,221,030 hospitalized patients who underwent PCI. These patients were further stratified based on the presence of MDD. A multivariate regression model was used to adjust for confounders and analyze the variables. Results: Only 5,380 (18%) patients with MI and MDD underwent PCI. There was no statistically significant difference regarding in-hospital mortality between patients with MDD who underwent PCI and those who underwent PCI but did not have MDD (2.7% vs. 3%; p=0.49). Patients with MDD who underwent PCI had a higher incidence of cerebrovascular accidents (CVA) compared to those who did not have MDD (1.8% vs 1.4%, p=0.0082). There was a higher incidence of in-stent restenosis (ISR) in patients who had MDD and underwent PCI compared to those who did not have MDD (7.1% vs. 4.9%; p=0.0013). When adjusted for age, comorbidities, gender, and hospital characteristics, patients with MDD had lower mortality than those without MDD with an odds ratio of 0.66. Conclusion: Although patients with MDD presenting with MI are a vulnerable population, it is likely that these patients are not always receiving the appropriate treatment. There is a higher incidence of cardiovascular events such as CVA, ISR, amongst other events. When adjusted for age, comorbidities, gender, and hospital characteristics, patients with MDD had lower mortality than those without MDD.