The association of depression following percutanous coronary intervention with adverse cardiovascular events Protocol for a systematic review and meta-analysis

Introduction: Percutanous coronary intervention (PCI) has been increasingly used for patients suffered from severe coronary artery disease. However, physical trauma and potential adverse events related to the procedure often result in detrimental psychological stress. Accumulating evidences have shown that depression is closely related to coronary artery disease. However, the association of depression following percutanous coronary intervention with adverse cardiovascular events is still unknown. Objective: This review is designed to assess the prognostic association of depression following PCI with adverse cardiac events. Methods and analysis: The following databases will be searched, PubMed, the EMBASE, CINAHL and Web of Science of English-language publications from inception to 30 October 2018. Cross-referencing from retrieved studies will be conducted additionally, and observational studies were included. Two independent review authors will do the study selection on the basis of the study eligibility criteria. Extracted data will be used for quantitative and qualitative evidence synthesis as well as to assess methodological quality of studies using the Newcastle-Ottawa checklist. The primary objective of this review is adverse cardiac events, presented as a composition of myocardial infarction, repeat coronary revascularization, cardiac readmission, and cardiac death. The accumulated evidence is evaluated and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results and conclusions: This review will explain the association of depression following percutanous coronary intervention with adverse cardiovascular events, and provide physicians with scientific evidence for psychological intervention in patients after PCI. Prospero registration number: CRD42018112486.