Antidepressant and Anxiolytic Medication use in Patients Treated With Coronary Artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention: a Danish Nationwide Population-based Study

Abstract

Background: Coronary artery bypass graft (CABG) surgery is considered the optimal revascularization strategy for patients with complex coronary artery disease (CAD), whereas in patients with less severe CAD percutaneous coronary intervention (PCI) is recommended. As a more invasive procedure may be associated with increased psychopharmaca use, we compared antidepressant and anxiolytic use between CABG and PCI patients. Methods: Patients treated with CABG or PCI between 1999 and 2012 were identified from the Danish Heart Registry. Psychopharmaca use was determined by claimed prescriptions up to 12 months. Results: We identified 62.912 patients: 10.347 CABG and 52.565 PCI patients. After propensity-score matching, antidepressant use was significantly higher in CABG patients at 6 and 12 months, although no difference was found on anxiolytic use. Absolute risk differences (ARD’s) ranged between 1.0-1.8% and risk ratios (RR’s) between 1.1 - 1.2. Conclusion: CABG patients were more often than PCI patients prescribed antidepressants. Given the small ARD’s and RR’s, these differences did not seem clinically relevant, possibly reflecting comparable underlying psychological distress levels.