Depression anticipates patients at risk of poor exercise stress test performance after percutaneous coronary angioplasty: A short-term longitudinal study

Aims: The exercise stress test is commonly used to assess physical capacity and recovery in coronary artery disease (CAD) patients after percutaneous transluminal coronary angioplasty (PTCA). Despite depressive symptoms have been consistently associated with adverse outcomes in CAD patients, they are rarely considered as risk factors of poor exercise test. The present study investigated the influence of depressive symptoms, along with anxiety, sleep problems and perceived health on exercise test in PTCA patients. Methods: One hundred and sixty-five patients who underwent PTCA completed the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory, the Sleep Condition Index and the 12-item Short-Form Health Survey and, after 20 days, underwent exercise stress test. Results: Higher BDI-II scores significantly predicted lower maximal workload measured in metabolic equivalents (METs; β = −0.13; p = .030), shorter total exercise duration (β = −5.23; p = .034) and the inability to reach maximum heart rate during exercise test (OR = 1.07; p = .032), even after controlling for relevant sociodemographic and biomedical risk factors. Conclusions: Depressive symptoms specifically predicted worse exercise stress test performance in patients after PTCA, controlling for common risk factors. Focusing on the assessment of depressive symptoms, in addition to sociodemographic and biomedical risk factors, is essential to anticipate patients at risk of poor physical capacity after PTCA.