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Ann Thorac Surg 2003;75:314-321
© 2003 The Society of Thoracic Surgeons

Review

Depression and anxiety and outcomes of coronary artery bypass surgery

Virginie Pignay-Demaria, MDa,c, François Lespérance, MDa,e, Roland G. Demaria, MD, PhDb,d, Nancy Frasure-Smith, PhDa,f, Louis P. Perrault, MD, PhDb*

a Department of Psychosomatic Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
b Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada
c Department of Medical Psychology and Psychiatry, Lapeyronie Hospital, Montpellier, France
d Department of Cardiovascular Surgery, Arnaud de Villeneuve Hospital, Montpellier Teaching Hospital, Montpellier, France
e Department of Psychiatry, University of Montreal Teaching Hospital, Montreal, Quebec, Canada
f Department of Psychiatry, McGill University, Montreal, Quebec, Canada

* Address reprint requests to Dr Perrault, Research Center, Montreal Heart Institute, 5000 Bélanger St, Montreal, QC H1T 1C8, Canada.
e-mail: lpperrau{at}icm.umontreal.ca

Psychological and psychiatric disorders independently increase the risk of cardiovascular disease and worsen the prognosis in patients with established cardiovascular lesions. The objective of this literature review is to discuss recent data concerning the relationships between depression and anxiety and the outcomes of coronary artery bypass grafting. Pathophysiological hypotheses are put forward to explain observed links. We suggest recommendations aimed at improving the psychological evaluation and management of heart surgery candidates, as well as postbypass patients, in the hope of improving quality of life and cardiovascular outcomes in these patients.




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