Depressive Symptoms After Cardiac Surgery

NCT ID: NCT06706323

Last Updated: 2025-04-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-11-25

Study Completion Date

2027-08-31

Brief Summary

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The primary goal of this project is to develop a predictive model for clinically significant depressive symptoms (CSDS) in patients undergoing coronary artery bypass graft (CABG) surgery, using pre- and perioperative data. CSDS occur in about 30 percent of CABG patients, which is four times higher than in the general population. These symptoms are linked to poor quality of life and increased morbidity and mortality. The aim is to create a model that can identify patients at risk for postoperative depression. This tool could help clinicians make informed decisions and take preventive measures to manage depression after surgery.

Detailed Description

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In patients undergoing coronary artery bypass graft (CABG) surgery, the prevalence of clinically significant depressive symptoms (CSDS) is about 30 percent, four times higher than the 12-month prevalence in the general population. CSDS are associated with poor quality of life and increased morbidity and mortality. While several predictors of post-CABG CSDS have been identified, no prognostic model exists.

The aim of this project is to develop a predictive model for post-surgery CSDS in CABG patients using pre- and perioperative data. A prognostic prediction model for CSDS 6 weeks post-CABG, will be developed using demographic, psychometric, medical, inflammation, and cardiac interoception data. Machine learning algorithms will be employed for data analysis. A cohort of 350 participants from two hospitals will be recruited, with 300 participants expected to complete the study. Data will be divided into training (200 participants) and testing (100 participants) sets. Nested cross-validation will prevent overfitting. Both binary and regression prediction models will be used. Additionally, a simpler model will be developed to increase generalizability.

The prediction model will identify CABG patients at risk of post-surgery CSDS. The model will help identify patients at risk for CSDS before surgery, enabling early interventions. Clinicians can make precision medicine decisions to prevent or manage CSDS, improving postoperative psychological well-being. Additionally, the study could advance understanding of the mechanisms linking depression and coronary heart disease, particularly in relation to inflammation and interoception.

Conditions

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Cardiovascular Diseases Coronary Artery Disease Heart Diseases Depression Depressive Symptoms Anxiety Posttraumatic Stress Disorder Quality of Life Psychological Well-Being Postoperative Complications

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Training group

From the final cohort of 300 participants, 200 will be recruited at Hospital I (University Hospital Zurich) to form the training group for developing the optimal statistical model.

No interventions assigned to this group

Test group

From the final cohort of 300 participants, the remaining 100 will be recruited at Hospital II (Stadtspital Zurich Triemli) to form the test group for validating the final model.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Elective Off-Pump CABG or CABG, either isolated or combined with valve intervention
* Men and women, aged between 18 and 90 years
* Sufficient knowledge of German language in reading and understanding
* Oral and Signed consent form
* Ability and Willingness to follow the study protocol

Exclusion Criteria

* Cognitive impairment according to a score of ≤ 7 (maximum score = 9) on a modified version of a short version of the Mini-Mental State Examination and the Brief Interview for Mental Status
* Any serious comorbid non-cardiac medical condition likely to cause death within 1 year (e.g. metastatic cancer)
* Active psychotic symptoms (assessed with two items from the Youth Psychosis At Risk Questionnaire), substance abuse and/or dependence within the past 6 months (assessed with a single-item questionnaire), and/or active suicidal ideations (assessed with a single item from the M.I.N.I.).
* Acute or emergency CABG
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Triemli Hospital

OTHER

Sponsor Role collaborator

ETH Zurich

OTHER

Sponsor Role collaborator

University of Zurich

OTHER

Sponsor Role collaborator

Roland von Känel

OTHER

Sponsor Role lead

Responsible Party

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Roland von Känel

Prof. Dr. med.

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Omer Dzemali, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Stadtspital Zürich Triemli, Klinik für Herzchirurgie, Birmensdorferstr. 497, 8063 Zurich, Switzerland

Roland v Känel, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

University Hospital Zurich, Dept. of Consultation-Liaison Psychiatry, Haldenbachstr. 16/18, 8091 Zurich, Switzerland

Locations

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Stadtspital Zürich (City Hospital Zurich) Triemli

Zurich, , Switzerland

Site Status RECRUITING

University Hospital Zurich (USZ)

Zurich, , Switzerland

Site Status NOT_YET_RECRUITING

Countries

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Switzerland

Central Contacts

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Roland v Känel, Prof. Dr.

Role: CONTACT

+41 (0)44 255 52 51

Sinthujan Sivakumar, MSc

Role: CONTACT

+41 (0)44 255 35 95

Facility Contacts

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Héctor Rodríguez, Dr. med.

Role: primary

+41 43 253 26 87

Sinthujan Sivakumar, MSc

Role: backup

+41 43 253 55 94

Héctor Rodríguez, Dr. med.

Role: primary

+41 43 253 26 87

Sinthujan Sivakumar, MSc

Role: backup

+41 43 253 55 94

References

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Chocron S, Vandel P, Durst C, Laluc F, Kaili D, Chocron M, Etievent JP. Antidepressant therapy in patients undergoing coronary artery bypass grafting: the MOTIV-CABG trial. Ann Thorac Surg. 2013 May;95(5):1609-18. doi: 10.1016/j.athoracsur.2013.02.035. Epub 2013 Apr 6.

Reference Type BACKGROUND
PMID: 23566649 (View on PubMed)

Correa-Rodriguez M, Abu Ejheisheh M, Suleiman-Martos N, Membrive-Jimenez MJ, Velando-Soriano A, Schmidt-RioValle J, Gomez-Urquiza JL. Prevalence of Depression in Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis. J Clin Med. 2020 Mar 26;9(4):909. doi: 10.3390/jcm9040909.

Reference Type BACKGROUND
PMID: 32225052 (View on PubMed)

Guo P. Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomised controlled trials. J Clin Nurs. 2015 Jan;24(1-2):34-46. doi: 10.1111/jocn.12618. Epub 2014 Jun 3.

Reference Type BACKGROUND
PMID: 24894181 (View on PubMed)

Protogerou C, Fleeman N, Dwan K, Richardson M, Dundar Y, Hagger MS. Moderators of the effect of psychological interventions on depression and anxiety in cardiac surgery patients: A systematic review and meta-analysis. Behav Res Ther. 2015 Oct;73:151-64. doi: 10.1016/j.brat.2015.08.004. Epub 2015 Aug 14.

Reference Type BACKGROUND
PMID: 26319588 (View on PubMed)

Ravven S, Bader C, Azar A, Rudolph JL. Depressive symptoms after CABG surgery: a meta-analysis. Harv Rev Psychiatry. 2013 Mar-Apr;21(2):59-69. doi: 10.1097/HRP.0b013e31828a3612.

Reference Type BACKGROUND
PMID: 23656830 (View on PubMed)

Takagi H, Ando T, Umemoto T; ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. Perioperative depression or anxiety and postoperative mortality in cardiac surgery: a systematic review and meta-analysis. Heart Vessels. 2017 Dec;32(12):1458-1468. doi: 10.1007/s00380-017-1022-3. Epub 2017 Jul 13.

Reference Type BACKGROUND
PMID: 28702898 (View on PubMed)

Tully PJ, Baker RA. Depression, anxiety, and cardiac morbidity outcomes after coronary artery bypass surgery: a contemporary and practical review. J Geriatr Cardiol. 2012 Jun;9(2):197-208. doi: 10.3724/SP.J.1263.2011.12221.

Reference Type BACKGROUND
PMID: 22916068 (View on PubMed)

Wittchen HU, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jonsson B, Olesen J, Allgulander C, Alonso J, Faravelli C, Fratiglioni L, Jennum P, Lieb R, Maercker A, van Os J, Preisig M, Salvador-Carulla L, Simon R, Steinhausen HC. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011 Sep;21(9):655-79. doi: 10.1016/j.euroneuro.2011.07.018.

Reference Type BACKGROUND
PMID: 21896369 (View on PubMed)

Related Links

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Other Identifiers

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215033

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

BASEC 2023-02040

Identifier Type: -

Identifier Source: org_study_id

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