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Abstract 13116: The Association Between Depression and Mortality and Amputation Outcomes in Patients With Peripheral Artery Disease: A Systematic Review and Meta-Analysis
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Abstract 13116: The Association Between Depression and Mortality and Amputation Outcomes in Patients With Peripheral Artery Disease: A Systematic Review and Meta-Analysis

Lindsey E Scierka, Zain V Ahmed, Sameh Yousef, AHMAD Arham, Alyssa A Grimshaw, Kristie Harris, Matthew Burg, Carlos Mena-hurtado and Kim G Smolderen
Circulation (New York, N.Y.), Vol.144(Suppl_1), pp.A13116-A13116
11/16/2021
DOI: 10.1161/circ.144.suppl_1.13116

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Abstract

Introduction: Peripheral artery disease (PAD) is associated with significant morbidity and mortality. Part of its management requires optimizing adherence to medications and lifestyle changes. Depression may negative affect this goal and has been identified as a potential risk factor for PAD incidence and progression. To better understand this risk, we conducted a systematic review and meta-analysis to summarize the strength of the association between depression and mortality and amputation in patients with PAD. Hypothesis: Comorbid depression is associated with an increased risk of mortality and amputation risk in patients with PAD. Methods: We performed a systematic search of Cochrane Library, Embase, Google Scholar, Medline, Pubmed, PsychInfo, Scopus, and Web of Science Core Collection databases for studies that report the comorbidity of depression or depressive symptoms in patients with PAD. Databases were searched on December 16th, 2020. Risk of bias was assessed used Cochrane ROBINS-I. Funnel plot and Egger's regression asymmetry test were used to assess publication bias. A random effects model was used to estimate the combined overall effect as odds ratio (OR) or hazard ratios (HR). Results: In the 6 studies included (n= 274,442 patients with PAD), 36,134 patients (13.2%) had comorbid depression. Depression was associated with an increased risk of mortality (HR 1.37, 95% CI 1.1-1.70, p-value: 0.003) and amputation (HR 1.21, 95% CI 1.02-1.45, p-value: 0.031). Risk of bias was moderate for all studies and Egger's test was not statistically significant (p-value: 0.127 for mortality, 0.867 for amputation). Conclusion: There is a 21% increased risk of amputation and 37% increase in risk of mortality in PAD patients with comorbid depression. Future work will need to study explanatory mechanisms and directionality of the association, while clinical implications include realizing integrated care to address the depression burden in patients with PAD.
 Peripheral artery disease (PAD) Mortality Depression Outcomes Vascular medicine

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