News in brief - Sept. 8, 2003

High coronary calcium score increases risk of death - Depression doubles risk of death after bypass surgery

High coronary calcium score increases risk of death

The amount of calcium that accumulates in coronary arteries may help predict whether individuals with no symptoms of heart disease will have a fatal event within five years, according to a large, multicenter study in the September Radiology.

"Our observational study of more than 10,000 patients over five years revealed that coronary artery calcium screening provides independent, incremental information over traditional risk factors in predicting death," said study co-author Paolo Raggi, MD, professor of medicine at Tulane University School of Medicine and associate chief of cardiology at Tulane University Hospital and Clinics in New Orleans.

Researchers followed 10,377 asymptomatic individuals who were referred between 1996 and 2000 for cardiac risk factor evaluation and coronary calcium screening. The study showed that survival at five years worsened substantially as the calcium scores increased from levels of 10 or less, to greater than 1,000.

Depression doubles risk of death after bypass surgery

Depression was found to be a strong independent risk factor for death among patients who have undergone coronary artery bypass surgery, according to a study in the Aug. 23 issue of The Lancet.

Because depression appears to double the chances of death, the researchers believe that bypass surgery patients should be screened to assess their likelihood of depression and treated if depression is detected.

Researchers at Duke University Medical Center in Durham, NC, analyzed the medical records of more than 800 patients who underwent bypass surgery at Duke. They found that patients with moderate to severe depression at the time of their surgery, or those with mild depression prior to surgery, were more than twice as likely to die during the follow-up period. Some patients were followed for as long as 12 years after surgery, with the average follow-up being 5.2 years.

Of the 817 patients who underwent surgery from 1989 to 2001, 122 patients, or 15% died. Patients who were already being treated for depression or other mental illnesses were excluded from the analysis.

During the 12-year follow-up period, 10% of the patients who were never depressed died, compared with 19% of patients who were persistently depressed, the researchers said.