Supplementary Material for: Association between Depression and Clinical Outcomes following Percutaneous Coronary Intervention: A Meta-Analysis

Background: Several studies suggested that depression was associated with poor prognosis following percutaneous coronary intervention (PCI) in coronary heart disease (CHD), whereas other studies showed that there were no associations between depression and poor outcomes. Objectives: Considering these problems, this meta-analysis was conducted to evaluate the relationship between depression and clinical outcomes after PCI. Methods: Articles published before July 2021 were analyzed from the databases: PubMed, Web of Science, EMBASE, Medline, and Google Scholar. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed to generate a pooled effect size and 95% CI with a random or fixed effects model. Q test and I2 were used to assess heterogeneities between studies. Results: The meta-analysis indicated that depression was associated with a higher risk of major adverse cardiac events (MACE) after PCI with a random effects model (HR = 1.89, 95% CI: 1.33–2.68, I2 = 57.0%, p = 0.023). The study indicated that depression was associated with a higher risk of all-cause mortality after PCI with a fixed effects model (HR = 1.71, 95% CI: 1.43–2.05, I2 = 0.0%, p = 0.756). The study indicated no significant association between depression and risk of repeat revascularization after PCI with a random effects model (HR = 2.10, 95% CI: 0.96–4.58, I2 = 68.9%, p = 0.022). Conclusion: Results indicated that depression is associated with adverse clinical outcomes in CHD patients’ post-PCI. Appropriate mental health check and psychological treatment may be necessary for the prognosis of CHD patients who receive PCI.

背景：已有多项研究表明，抑郁症与冠心病（coronary heart disease, CHD）患者行经皮冠状动脉介入治疗（percutaneous coronary intervention, PCI）后的不良预后存在关联，但另有部分研究显示，抑郁症与不良临床结局并无显著相关性。
目的：鉴于上述研究结论存在分歧，本研究开展此项荟萃分析，旨在评估抑郁症与PCI术后临床结局之间的关联。
方法：检索2021年7月之前发表于PubMed、Web of Science、EMBASE、Medline及Google Scholar数据库的相关文献。采用随机效应模型或固定效应模型计算风险比（hazard ratios, HRs）与95%置信区间（95% confidence intervals, CIs），以得到合并效应量及对应95%CI；通过Q检验与I²统计量评估各研究间的异质性。
结果：本次荟萃分析结果显示，采用随机效应模型分析时，抑郁症与PCI术后更高的主要不良心血管事件（major adverse cardiac events, MACE）发生风险相关（HR=1.89，95%CI：1.33~2.68，I²=57.0%，p=0.023）。采用固定效应模型分析时，抑郁症与PCI术后更高的全因死亡率风险相关（HR=1.71，95%CI：1.43~2.05，I²=0.0%，p=0.756）。采用随机效应模型分析时，未发现抑郁症与PCI术后重复血运重建风险存在显著关联（HR=2.10，95%CI：0.96~4.58，I²=68.9%，p=0.022）。
结论：本研究结果表明，抑郁症与接受PCI治疗的冠心病患者术后不良临床结局显著相关。对这类患者开展恰当的心理健康筛查与心理干预，或对改善其预后具有重要意义。