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Study Protocol: Longitudinal course of depressive, anxiety and post-traumatic stress disorder symptoms after heart surgery Review question What is the longitudinal course of depressive, anxiety, and post-traumatic stress-disorder (PTSD) symptoms in cardiac patients undergoing heart surgery? Searches PubMed and Scopus, up to 07/31/2019, search key: ("implantable cardiac defibrillator" OR "cardiac operation" OR "heart surgery" OR "cardiac surgery" OR "coronary artery bypass" OR "open heart surgery" OR "valve surgery" OR “heart transplant*”) AND ((("depression" OR "depressive") AND "episode") OR "major depressive disorder" OR "anxiety" OR "PTSD" OR "post-traumatic stress disorder" OR "acute stress- reaction" OR "quality of life"). The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations will be used to guide this meta-analysis. (1) Inclusion criteria Cohort studies measuring depressive, anxiety, or PTSD symptoms with validated psychometric tools, before and at least 1 month after heart surgery. Exclusion criteria Article type different from cohort study (interventional, review article, meta-analysis, editorial, conference abstract, case report). Language other than English. Publication date antecedent to 1980. Population Cardiac patients scheduled for heart surgery. Exposure Cardiac surgery, whether first time or more. Comparator Post-surgical depressive, anxiety, and PTSD symptoms, whether reported as mean scores or rates by the authors, will be compared with the pre-surgical levels in the same study population. Primary outcome Primary outcome will be the pre-post change in depressive, anxiety, and PTSD symptoms following surgery, measured as standardized effect size. Supplemental Digital Content

Transcript of Supplemental Digital Content

Study Protocol: Longitudinal course of depressive, anxiety and post-traumatic stress disorder

symptoms after heart surgery

Review question

What is the longitudinal course of depressive, anxiety, and post-traumatic stress-disorder (PTSD)

symptoms in cardiac patients undergoing heart surgery?

Searches

PubMed and Scopus, up to 07/31/2019, search key: ("implantable cardiac defibrillator" OR "cardiac

operation" OR "heart surgery" OR "cardiac surgery" OR "coronary artery bypass" OR "open heart surgery"

OR "valve surgery" OR “heart transplant*”) AND ((("depression" OR "depressive") AND "episode") OR

"major depressive disorder" OR "anxiety" OR "PTSD" OR "post-traumatic stress disorder" OR "acute stress-

reaction" OR "quality of life").

The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations will

be used to guide this meta-analysis. (1)

Inclusion criteria

Cohort studies measuring depressive, anxiety, or PTSD symptoms with validated psychometric tools, before

and at least 1 month after heart surgery.

Exclusion criteria

Article type different from cohort study (interventional, review article, meta-analysis, editorial,

conference abstract, case report). Language other than English. Publication date antecedent to 1980.

Population

Cardiac patients scheduled for heart surgery.

Exposure

Cardiac surgery, whether first time or more.

Comparator

Post-surgical depressive, anxiety, and PTSD symptoms, whether reported as mean scores or rates by the

authors, will be compared with the pre-surgical levels in the same study population.

Primary outcome

Primary outcome will be the pre-post change in depressive, anxiety, and PTSD symptoms following

surgery, measured as standardized effect size.

Supplemental Digital Content

Secondary Outcomes

Secondary outcomes will be: 1) the durability of mental health symptom changes; 2) the correlation

between baseline demographic and clinical characteristics and improvement in mental health scores.

Strategy for data synthesis

A random-effects meta-analysis of pre-post changes in the mental health symptoms assessed with

psychometric tools will be performed. A pre-post correlation coefficient of 0.5 if not otherwise specified

will be assumed. Binary and continuous outcomes will be pooled together. Subgroup analyses will be

performed for: type of heart surgery; studies that included subjects with psychiatric disorders at baseline

or not; among regions; among subjects undergoing HS for the first time or more; among follow-up

duration ranges (1-3 months, ≥3-6 months, ≥6-12 months , >1 year); and among modalities for reporting

the outcome (binary versus continuous). Moderators to investigate with meta-regression will be mean

age, % married, % white, % males, % with specific medical comorbidities, and % smoking.

Quality assessment

Quality of cohort studies will be assessed with Newcastle-Ottawa Scale. (2)

Bibliography

1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ,

Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of

studies that evaluate health care interventions: explanation and elaboration. In: J. Clin. Epidemiol.

2009. p. e1–34.

2. Wells G, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Al. E. The Newcastle-Ottawa Scale (NOS)

for assessing the quality if nonrandomized studies in meta-analyses. Ottawa Hospital Research

Institute, editor. Ottawa; Available from:

http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp2017.

Supplementary figure 1. Forest plot of Depressive symptoms studies

Supplementary figure 2. Forest plot of Anxiety symptoms studies

Supplementary figure 3. Forest plot of PTSD symptoms

Legend. PTSD, Post-Traumatic Stress Disorder.

Supplementary figure 4. Funnel plot of Depressive symptoms studies

Supplementary figure 5. Funnel Plot of Anxiety symptoms studies

Supplementary figure 6. Funnel plot of PTSD symptoms studies

Legend. PTSD, Post-traumatic stress disorder.

1

Supplementary table 1. Characteristics of included studies

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

AbuRuz, 2019

(1) Jordan CABG CAD 227 66.1 1.5 -

HADS (2)

(HADS ≥8) - -

Baranyi, 2013

(3) Germany HT HF 62 54.4 24.9 - - -

PTSS-10 (4)

(PTSS-10 ≥35)

Bech , 1984 (5) Denmark Mixed

CAD,

valve

disease

30 54.0 6 - - HARS (6)

-

Bidwell, 2017

(7) USA

VAD

Implantation HF 41 53.8 3 - PHQ-8 (8) BSI (9) -

Blumenthal,

2003 (10) USA CABG CAD 817 61.0 6 -

CES-D (11)

(CES-D ≥16) - -

Borowicz, 2002

(12) USA CABG CAD 172 63.4 60 -

CES-D (11)

(CES-D ≥16) - -

Botzet, 2017

(13) Germany

Mitral valve

surgery

Valve

disease 100 64.6 6 -

HADS (2)

(HADS ≥8)

HADS (2)

(HADS ≥8) -

Burg, 2003 (14) USA CABG

CAD 89 65.9 6

1. No pre-surgical

depression (N 64)

2. Presurgical depression

(N 25)

BDI (15)

(BDI≥10) - -

2

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

(Depression was assessed

with BDI according to

authors’ criteria) (15)

Burker, 1995

(16) USA Mixed

CAD,

valve

disease

247 61.0 1.5 - CES-D (11) HADS (2) -

Chunta, 2009

(17) USA Mixed

CAD,

valve

disease

54 63.5 1 - HADS (2)

(HADS ≥8)

HADS (2)

(HADS ≥8) -

Connolly, 2004

(18) USA Mixed

Mixed

conditions 43 8.2 1.5 - - -

DISC (19)

(Anxiety Module)

Crow, 1998 (20) USA ICD

implantation

SCA/Ventr

icular

arrhythmia

35 N/A 12.3 - DSM-III-R SCID (21)

(MDD module)

DSM-III-R SCID (21)

(Panic Disorder

module)

-

Dannemann,

2010 (22) Germany Mixed

CAD,

valve

disease

126 67.0 6

1. Non-Type D

personality before

and after surgery (N

77)

HADS (2)

HADS (2)

-

3

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

2. Type D personality

only before surgery

(N 19)

3. Type D personality

only after surgery (N

16)

4. Type D personality

before and after

surgery (N 14)

(Type D personality was

assessed with DS14) (23)

Deshields, 1996

(24) USA HT HF 10 50.3 12

-

BDI (15) BAI (25) -

Doering, 2006

(26) USA CABG CAD 55 62.5 6 -

DISH (27)

(MDD module) - -

Doering, 2014

(28) USA Mixed

CAD,

valve

disease

251 67.3 1.5 - BDI (15)

(BDI ≥10) - -

Duits, 1999 (29) Netherland

s CABG CAD 217 60.8 6 - HADS (2) STAI (30) -

4

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

Edéll-

Gustafsson,

1999 (31)

Sweden CABG CAD 38 61.3 6 - Zung’s SDS (32)

(Zung’s SDS ≥50)

SSAI (30)

(SSAI ≥43)

-

Egan, 1998 (33) UK Mixed

CAD,

valve

disease

55 63.5 2 - - SSAI (30) -

Eremina, 2017

(34) Russia CABG CAD 70 59.7 3 - - ITT (35) -

Eriksson, 1988

(36) Finland CABG CAD 101 52.2 7.5 -

BDI (15)

(BDI ≥14)

HARS (6)

(HARS ≥11) -

Fisher, 1995

(37) USA HT HF 94 53 60 - BDI (15) - -

Geulayov, 2018

(38) Israel Mixed

CAD,

valve

disease

1125 65.7 12 - HADS (2)

(HADS ≥8)

HADS (2)

(HADS ≥8) -

Goyal, 2005 (39) USA Mixed

CAD,

valve

disease

90 66.0 6 - BDI (15)

(BDI ≥9) - -

Grigioni, 2005

(40) Italy HT HF 127 52 12 -

DSM-IV SCID (41)

(MDD + Dysthymic

Disorder modules)

- -

5

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

Grossi, 1998

(42) Sweden CABG CAD 61 66.0 12 - - STAI (30) -

Guzelhan, 2018

(43) Turkey CABG CAD 137 68.2 6

1. Female (N 41)

2. Male (N 96)

- STAI (30) -

Hallas, 2003

(44) UK CABG CAD 22 62.0 2 -

HADS (2)

(HADS ≥8)

HADS (2)

(HADS ≥8) -

Heijmeriks,

1999 (45)

Netherland

s Mixed

CAD,

valve

disease

600 69.3 6

1. Age ≥ 75 (N 200)

2. Age <75 (N 400) HADS (2) HADS (2) -

Höfer, 2006 (46) Austria CABG CAD 121 63.1 3 - HADS (2) HADS (2) -

Horne, 2013

(47) Canada Mixed CAD 436 65.5 6

1. “Depression” at

baseline per authors’

criteria (N 104)

2. "At risk" for

depression at baseline

per authors’ criteria

(N 167)

3. "Naive" to depression

at baseline per

PHQ-9 (8)

(PHQ>9, or PHQ 5-9

with>3 items)

- -

6

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

authors’ criteria (N

165)

Hoyer, 2008

(48) Germany Mixed

CAD,

valve

disease

90 66.9 6

1. Undergoing CABG

(N 60)

2. Undergoing valve

replacement (N 22)

3. Undergoing

combined surgery

(CABG and valve

replacement) (N 8)

HADS (2) HADS (2) -

Jenkins, 1983 (a)

(49) USA CABG CAD 318 54.4 6 - - SSAI (30) -

Jenkins, 1983

(b) (50) USA Mixed

CAD,

valve

disease

89 56.8 6 - - SSAI (30) -

Jones, 1992 (51) Australia HT HF 27 44.6 50 - BDI (15) STAI (30) -

Karapolat, 2007

(52) Turkey HT HF 34 41.4 19.3 - BDI (15) STAI (30) -

Khatri, 2001

(53) USA CABG CAD 226 61.5 6

1. Surgery with

hypothermia (N 111)

CES-D (11)

(CES-D ≥16)

STAI (30)

(STAI ≥45) -

7

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

2. Surgery with

normothermia (N

115)

Khatri, 1999

(54) USA CABG CAD 170 61.0 1.5 - CES-D (11) STAI (30) -

Khoueiry, 2011

(55) USA CABG CAD 50 63.3 9 - BDI (15) BAI (25) -

Kidd, 2016 (56) UK Mixed

CAD,

valve

disease

155 68.2 12 - BDI (15)

(BDI ≥10)

HADS (2)

(HADS≥8) -

Klonoff, 1989

(57) Canada CABG CAD 135 55.4 24 -

MMPI-168 (58)

(Depression domain) - -

Koivula, 2002

(59) Finland CABG CAD 171 62.3 3 - - STAI (30) -

Korbmacher,

2013 (60) Germany CABG CAD 135 72.0 6 -

HADS (2)

(HADS≥8)

HADS (2)

(HADS≥8) -

Krauseneck,

2010 (61) Germany Mixed

CAD,

valve

disease

128 61.9 6 - - - PTSS-10 (4)

Kustrzycki,

2012 (62) Poland CABG CAD 37 58.2 96 - BDI (15) SSAI (30) -

8

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

Langeluddecke,

1989 (63) Australia CABG CAD 89 56.0 12 -

CES-D (11)

(CES-D ≥16)

SSAI (30)

(SSAI ≥85th percentile) -

Lindquist, 2003

(64) USA CABG CAD 674 N/A 12

1. Male (N 405)

2. Female (N 269) CES-D (11) STAI (30) -

Lopez, 2007

(65)

Hong

Kong CABG CAD 68 63.9 6 - CES-D (11) - -

Mai, 1986 (66) Canada HT HF 66 N/A 12 - PSE (67) - -

McCrone, 2001

(68) USA CABG CAD 31 70.0 3 -

CES-D (11)

(CES-D ≥16) - -

McKhann, 1997

(69) USA CABG CAD 124 63.0 12 -

CES-D (11)

(CES-D ≥16) - -

Middel, 2014

(70)

Netherland

s CABG CAD 198 64.9 6

1. Non-Type D

personality before

surgery (N 23)

2. Type D personality

before surgery (N

175)

(Type D personality was

assessed with DS14) (23)

HADS (2) HADS (2) -

Millar, 2001

(71) UK CABG CAD 81 60.0 6 -

BDI (15)

(BDI ≥9) - -

9

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

Misra, 1982 (72) UK Mixed Mixed 21 N/A 6

1. Class I NYHA 6

months after the

operation (N 13) (73)

2. Class II NYHA 6

months after the

operation (N 8) (73)

BHPT (74) IPAT Anxiety Scale

(75) -

Mitchell, 2005

(76) Canada CABG CAD 130 63.3 2

1. Female (N 61)

2. Male (N 69)

MINI (77)

(Depressive Episode

Module)

- -

Murphy, 2008

(78) Australia CABG CAD 184 65.6 6 -

HADS (2)

(HADS≥8)

HADS (2)

(HADS≥8) -

Nemati, 2011

(79) Iran CABG CAD 139 57.8 1

1. Assessed for anxiety

(N 68)

2. Assessed for

depression (N 71)

HDRS (80) HARS (6) -

Nunes, 2013

(81) Brazil CABG CAD 57 N/A 6 -

BDI (15)

(BDI≥10) - -

Okkonen, 2006

(82) Finland CABG CAD 270 60.6 6

1. Living alone (N 57)

2. Having a domestic

support (N 213)

BDI (15) EMAS (83) -

10

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

Oxman, 1997

(84) USA Mixed CAD 147 69.0 6 - HDRS (80) - -

Pagé, 2017 (85) Canada Mixed

CAD,

valve

disease

1071 62.8 24 - HADS (2)

(HADS ≥8)

HADS (2)

(HADS ≥8) -

Patron, 2016

(86) Italy Mixed

CAD,

valve

disease

75 64.1 12 - CES-D (11)

(CES-D ≥16) - -

Patron, 2014

(87) Italy Mixed

CAD,

valve

disease

96 63.6 3

-

CES-D (11)

(CES-D ≥16) - -

Patron, 2013

(88) Italy Mixed

CAD,

valve

disease

42 64.1 18 - CES-D (11)

(CES-D ≥16) - -

Pearlman, 2014

(89) USA CABG CAD 201 63.9 6

1. Undergoing

additional biomarkers

measurement (N 50)

2. Undergoing standard

assessment (N 151)

BDI-II (90) - -

11

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

Petersen, 2016

(91) Germany Mixed

CAD,

valve

disease

60 62.0 6

-

HADS (2) HADS (2) -

Peterson, 2002

(92) USA CABG CAD 123 65.3 36

1. CES-D score

increased <5 points

6-months after

surgery (N 101)

2. CES-D score

increased ≥5 points

6-months after

surgery (N 22)

CES-D (11)

(CES-D ≥16) - -

Phillips-Bute,

2006 (93) USA CABG CAD 732 61.9 12 - CES-D (11) SSAI (30) -

Phillips-Bute,

2008 (94) USA CABG CAD 427 63.1 12

1. Male (N 299)

2. Female (N 128)

CES-D (11)

(CES-D ≥16) - -

Pinton, 2006

(95) Brazil CABG CAD 58 61.2 3 -

BDI (15)

(BDI≥10) - -

Pirraglia, 1999

(96) USA CABG CAD 237 65.3 6 -

CES-D (11)

(CES-D ≥16) - -

12

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

Poole, 2016 (97) UK Mixed

CAD,

valve

disease

171 69.3 12 - BDI (15)

(BDI≥10) - -

Reynard, 2014

(98) USA

VAD

implantation HF 19 55 12 - PHQ-9 (8)

GAD-7 (99) -

Riether, 1992

(100) USA HT HF 15 45.8 6 - BDI (15) STAI (30) -

Rothenhäusler,

2010 (101) Austria CABG CAD 147 N/A 6 -

BDI (15)

(cut-off N/A) -

PTSS-10 (4)

(cut-off N/A)

Rothenhäusler,

2005 (102) Germany Mixed

CAD,

valve

disease

34 68.2 12 - DSM-IV SCID (41)

(MDD Module) - PTSS-10 (4)

Rymaszewska,

2003 (103) Poland CABG CAD 53 58.6 3 -

BDI (15)

(cut-off N/A)

STAI (30)

(cut-off N/A) -

Sánchez, 2016

(104) Spain HT HF 78 55.8 12 - HADS (2) HADS (2) -

Sandau, 2008

(105) USA CABG CAD 64 65.2 3 -

CES-D (11)

(CES-D ≥16) SSAI (30) -

Schreiber, 2004

(106) Israel Mixed

CAD,

valve

disease

63 68.8 6 - - - IES (107)

(IES ≥18)

13

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

Sorensen, 2009

(108) USA CABG CAD 70 72.0 1.5

1. Male (N 46)

2. Female (N 24)

GDS (109)

(GDS ≥5) - -

Stroobant, 2008

(110) Belgium CABG CAD 53 59.4 48 -

BDIc-a (111)

(BDIc-a ≥4)

STAI (30)

(STAI ≥50) -

Sveinsdóttir,

2012 (112) Iceland Mixed

CAD,

valve

disease

66 64.3 1 - HADS (2) HADS (2) -

Tarsitani, 2012

(113) Italy Mixed

CAD,

valve

disease

71 66.9 6 - - - PTSS-10 (4)

(PTSS-10 ≥35)

Thomas, 2016

(114) India CABG CAD 100 55.2 1.25 - HADS (2) HADS (2) -

Thornton, 2005

(115) UK CABG CAD 71 61.0 6 - HADS (2) HADS (2) -

Timberlake,

1997 (116) UK CABG CAD 121 56.0 12 -

BDI (15)

(BDI ≥9) - -

Triffaux, 2001

(117) Belgium HT HF 15 53.3 6 - BDI (15) STAI (30) -

Tully, 2009

(118) Australia CABG CAD 86 65.1 60 -

DASS (119)

(DASS-D ≥10)

DASS (119)

(DASS-A ≥8) -

14

Study Country Surgery

procedure

Main

cardiac

condition

for

surgery

N Mean

age

Follow-

up

(months)

Additional Characteristics in

Subgroups

Depression

Assessment Tool

(Criteria for

dichotomous outcome)

Anxiety Assessment

Tool

(Criteria for

dichotomous outcome)

PTSD Assessment Tool

(Criteria for

dichotomous outcome)

Vaccarino, 2003

(120) USA CABG CAD 1113 64.1 1.5

1. Male (N 804)

2. Female (N 309)

GDS (109)

Vedin, 2006

(121) Sweden CABG CAD 70 65.0 6

1. On pump CABG (N

37)

2. Off pump CABG (N

33)

GDS (109)

STAI-Form Y-1 (30) -

Walden, 1994

(122) USA HT HF 19 51 39 -

MAACL Depression

(123) MAACL Anxiety (123) -

Wray, 2004

(124) UK HT HF 11 12.2 12 -

DSM-III-R SCID (21)

(MDD) - -

Yang, 2012

(125) China CABG CAD 232 60.8 6 -

PHQ-9 (8)

(PHQ-9 ≥10) - -

Legend. BAI, Beck Anxiety Inventory; BDI, Beck Depression Inventory; BDIc-a, Beck Depression Inventory Cognitive-Affective Domain; BDI-II, Beck Depression Inventory Version II; BHPT, British Hospital Progress Test; BSI, Brief Symptom Inventory; CABG, coronary artery by-pass graft; CAD, coronary artery disease; CES-D, Center for Epidemiologic Studies Depression Scale; DASS, Depression Anxiety and Stress Scales; DASS-A, Depression Anxiety and Stress Scales-Anxiety Domain; DASS-D, Depression Anxiety and Stress Scales Depression Domain; DISC-IV, Diagnostic Interview Schedule for Children Version IV; DISH, the Depression Interview and Structured Hamilton; DSM, the Diagnostic and Statistical Manual of mental disorders; DS14, 14 items Type-D Scale; EMAS, Endler Multidimensional Anxiety Scales; GAD-7, General Anxiety Disorder-7; HADS, the Hospital Anxiety and Depression Scale; HARS, Hamilton Anxiety Rating Scale; HF, heart failure; HT, heart transplant; ICD, implantable cardioverter defibrillator; IES, the Impact of Event Scale; IPAT, Institute for Personality and Ability Testing; ITT, Integrative Anxiety Test; MMACL, The Multiple Affect Adjective Checklist; MDD, Major Depressive Disorder; MINI, Mini-International Neuropsychiatric Interview; MMPI-168, 168 item Minnesota Multiphasic Personality Inventory; N/A, not available; NYHA, New York Heart Association; PHQ, Patient Health Questionnaire depression scale; PSE, Present State Examination; PTSS-10, Post-Traumatic Stress Scale-10; SCA, sudden cardiac arrest; SCID, Structured Clinical Interview for DSM; SDS, Self-Rating Depression Scale; SSAI, Spielberg’s State Anxiety Inventory; STAI, State-Trait Anxiety Inventory; VAD, ventricular assist device.

15

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1

Supplementary table 2 - Random-effects meta-regression of potential moderators of depressive and anxiety symptoms after heart surgery

Depressive symptoms Anxiety symptoms

Moderator K (subgroups) Beta (95%CI) P value Moderator K (subgroups) Beta (95%CI) P value

Age 75 (94) -0.05 (-0.07 - -0.03) <0.001 Age 50 (61) -0.02 (-0.05 – 0.00) 0.108

Married 38 (50) 1.17 (-0.61 – 2.96) 0.197 Married 26 (33) 0.92 (-1.97 – 3.80) 0.534

Sex 77 (97) -0,15 (-0.77 – 0.47) 0.632 Sex 51 (63) 0.16 (-0.06 - 0.39) 0.159

Ethnicity (white) 29 (34) -0.62 (-1.39 – 0.14) 0.111 Ethnicity (white) 12 (13) 0.35 (-0.57 - 1.26) 0.459

AMI 17 (21) -0.03 (-2.10 – 2.03) 0.975 AMI 8 (10) N/A N/A

Diabetes 36 (48) -1.48 (-2.93 – -0.02) 0.047 Diabetes 17 (21) -0.51 (-2.92 – 1.89) 0.677

Heart Failure 14 (15) 1.02 (0.70 – 1.33) <0.001 Heart Failure 9 (10) N/A N/A

Hypertension 30 (40) -1.16 (-1.97 - -0.35) 0.005 Hypertension 16 (20) -0.30(-1.56 – 0.97) 0.646

Dyslipidemia 14 (21) -1.16 (-2.36 – -0.01) 0.047 Dyslipidemia 10 (13) 0.19 (-1.31 – 1.69) 0.805

Pulmonary Disease 16 (21) -0.36 (-5.00 – 4.28) 0.879 Pulmonary Disease 9 (11) N/A N/A

Smoking 29 (40) 0.05 (-0.77 – 0.86) 0.907 Smoking 16 (20) -0.93 (-2.21 – 0.35) 0.155

LVEF% 13 (18) 0.90 (-0.78 – 2.57) 0.293 LVEF% 3 (5) N/A N/A

2

Legend. 95% CI, 95% confidence interval; AMI, acute myocardial infarction; LVEF, left ventricular ejection fraction; N/A, not applicable. Bold values indicate

significant findings.

1

Supplementary table 3. Quality of cohort studies according to Newcastle-Ottawa Scale

Author Year Selection

Compara

bility Outcome

Overall

Representati

veness of

the Exposed

Cohort

Selection of

the Non-

Exposed

Cohort

Ascert

ainme

nt of

Expos

ure

Demonstration

That Outcome

of Interest Was

Not Present at

Start of Study

Comparab

ility of

Cohorts

Assessment

of Outcome

Was Follow-

Up Long

Enough for

Outcomes to

Occur

Adequacy

of Follow

Up of

Cohorts

AbuRuz (1) 2019 ★ ★ ★ ★ ★ ★ 6

Baranyi (2) 2013 ★ ★ ★ ★ ★ ★ ★ ★ 8

Bech (3) 1984 ★

★ ★

★ ★ ★ 6

Bidwell (4) 2017 ★ ★ ★ ★ ★ ★ ★ 6

Blumenthal (5) 2003 ★

★ ★

★ ★ ★ 6

Borowicz (6) 2002 ★

★ ★ ★ 5

Botzet (7) 2017 ★

★ ★ ★ 5

Burg (8) 2003 ★

★ ★ ★ 5

Burker (9) 1995 ★

★ ★

4

Chunta (10) 2009 ★

★ ★ ★ 5

2

Connolly (11) 2004 ★

★ ★ ★ 5

Crow (12) 1998 ★ ★ ★ ★ ★ 5

Dannemann (13) 2010 ★

★ ★ ★ 5

Deshields (14) 1996 ★ ★ ★ ★ ★ 5

Doering (15) 2006

★ ★

★ ★ ★ 5

Doering (16) 2014 ★

★ ★ ★ 5

Duits (17) 1999 ★

★ ★

★ ★ ★ 6

Edéll-Gustafsson

(18) 1999 ★

★ ★

★ ★ ★

6

Egan (19) 1998 ★

★ ★ ★ 5

Eremina (20) 2017 ★ ★ ★ ★ ★ 5

Eriksson (21) 1988 ★

★ ★ ★ 5

Fisher (22) 1995 ★ ★ ★ ★ 4

Geulayov (23) 2018 ★ ★ ★ ★ ★ 5

Goyal (24) 2005 ★

★ ★ ★ 5

Grigioni (25) 2005 ★ ★ ★ ★ ★ 5

Grossi (26) 1998 ★

★ ★ ★ 5

Guzelhan (27) 2018 ★ ★ ★ ★ ★ ★ 6

3

Hallas (28) 2003 ★

★ ★

★ ★ ★ 6

Heijmeriks (29) 1999 ★

★ ★ ★ 5

Höfer (30) 2006 ★ ★ ★

★ ★ ★ 6

Horne (31) 2013 ★

★ ★ ★ 5

Hoyer (32) 2008 ★

★ ★ ★ 5

Jenkins (33) 1983 ★

★ ★ ★ 5

Jenkins (34) 1983 ★

★ ★ ★ 5

Jones (35) 1992 ★ ★ ★ ★ ★ 5

Karapolat (36) 2007 ★ ★ ★ ★ ★ ★ 6

Khatri (37) 2001 ★

★ ★

★ ★ ★ 6

Khatri (38) 1999 ★

★ ★ ★ 5

Khoueiry (39) 2011 ★

★ ★ ★ 5

Kidd (40) 2016 ★

★ ★ ★ 5

Klonoff (41) 1989 ★

★ ★ ★ 5

Koivula (42) 2002 ★

★ ★ ★ 5

Korbmacher (43) 2013 ★

★ ★ ★ 5

Krauseneck (44) 2010 ★

★ ★

★ ★ ★ 6

4

Kustrzycki (45) 2012 ★

★ ★ ★ 5

Langeluddecke

(46) 1989 ★

★ ★ ★

5

Lindquist (47) 2003 ★

★ ★

★ ★ ★ 6

Lopez (48) 2007 ★

★ ★

★ ★ ★ 6

Mai (49) 1986 ★ ★ ★ ★ 4

McCrone (50) 2001 ★

★ ★ ★ 5

McKhann (51) 1997 ★

★ ★ ★ 5

Middel (52) 2014 ★

★ ★ ★ 5

Millar (53) 2001 ★

★ ★ ★ 5

Misra (54) 1982 ★

★ ★ ★ 5

Mitchell (55) 2005 ★

★ ★

4

Murphy (56) 2008 ★

★ ★ ★ 5

Nemati (57) 2011 ★

★ ★ ★ 5

Nunes (58) 2013 ★

★ ★

★ ★ ★ 6

Okkonen (59) 2006 ★

★ ★ ★ 5

Oxman (60) 1997 ★

★ ★ ★ 5

Pagé (61) 2017 ★

★ ★ ★ 5

5

Patron (62) 2016 ★

★ ★

★ ★ ★ 6

Patron (63) 2014 ★

★ ★

★ ★ ★ 6

Patron (64) 2013 ★

★ ★

★ ★ ★ 6

Pearlman (65) 2014 ★

★ ★ ★ 5

Petersen (66) 2016 ★

★ ★ ★ 5

Peterson (67) 2002 ★

★ ★

★ ★ ★ 6

Phillips-Bute

(68) 2006 ★

★ ★

★ ★ ★

6

Phillips-Bute

(69) 2008 ★

★ ★ ★

5

Pinton (70) 2006 ★

★ ★ ★ 5

Pirraglia (71) 1999 ★

★ ★ ★ 5

Poole (72) 2016 ★

★ ★ ★ 5

Reynard (73) 2014 ★ ★ ★ ★ ★ 5

Riether (74) 1992 ★ ★ ★ ★ ★ ★ ★ 7

Rothenhäusler

(75) 2010 ★

★ ★ ★

5

6

Rothenhäusler

(76) 2005 ★

★ ★ ★

5

Rymaszewska

(77) 2003 ★

★ ★ ★

5

Sánchez (78) 2016 ★ ★ ★ ★ ★ 5

Sandau (79) 2008 ★

★ ★ ★ 5

Schreiber (80) 2004 ★

★ ★ ★ 5

Sorensen (81) 2009 ★

★ ★ ★ 5

Stroobant (82) 2008 ★

★ ★

★ ★ ★ 6

Sveinsdóttir (83) 2012 ★

★ ★ ★ 5

Tarsitani (84) 2012 ★

★ ★

★ ★ ★ 6

Thomas (85) 2016 ★

★ ★ ★ 5

Thornton (86) 2005 ★

★ ★

★ ★ ★ 6

Timberlake (87) 1997 ★

★ ★ ★ 5

Triffaux (88) 2001 ★ ★ ★ ★ ★ 5

Tully (89) 2009 ★ ★ ★

★ ★ ★ ★ 7

Vaccarino (90) 2003 ★

★ ★ ★ 5

Vedin (91) 2006 ★

★ ★ ★ 5

7

Walden (92) 1994 ★ ★ ★ ★ ★ ★ 6

Wray (93) 2004 ★ ★ ★ ★★ ★ ★ ★ 8

Yang (94) 2012 ★

★ ★ ★ 5

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71. Pirraglia PA, Peterson JC, Williams-Russo P, Gorkin L, Charlson ME. Depressive symptomatology in coronary artery bypass graft surgery patients.

Int. J. Geriatr. Psychiatry. 1999;14:668–80.

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1

Supplementary table 4. List of studies excluded after full-text assessment, with reason for exclusion

Study Year Reason for exclusion

Gotzmann, L. (1) 2002 Case report

Kong M.H. (2) 2008 Case report

Ai A.L. (3) 2006 Follow-up duration

Anderson E.A. (4) 1987 Follow-up duration

Arthur H.M. (5) 2000 Follow-up duration

Artinian N.T. (6) 1995 Follow-up duration

Ashton, C. (7) 1997 Follow-up duration

Ashton, RC. (8) 1995 Follow-up duration

Asilioglu K (9) 2003 Follow-up duration

Aygin, D. (10) 2019 Follow-up duration

Babaee, S. (11) 2012 Follow-up duration

Bagheri-Nesami, M. (12) 2014 Follow-up duration

Baker, RA. (13) 2001 Follow-up duration

Blankfield R.P. (14) 1995 Follow-up duration

Burker, EJ. (15) 1995 Follow-up duration

Chandrababu, R. (16) 2019 Follow-up duration

Chaudhury, S. (17) 2006 Follow-up duration

Christopherson B. (18) 1980 Follow-up duration

Con A.H. (19) 1999 Follow-up duration

Connerney I. (20) 2001 Follow-up duration

Coombs D.W. (21) 1986 Follow-up duration

Coskunturk, A.E. (22) 2018 Follow-up duration

De Feo S. (23) 2002 Follow-up duration

Deyirmenjian, M. (24) 2006 Follow-up duration

Duits, A.A. (25) 1996 Follow-up duration

2

Folks D.G. (26) 1988 Follow-up duration

Fráguas Júnior, R. (27) 2000 Follow-up duration

Gallagher R. (28) 2004 Follow-up duration

Gallagher, R. (29) 2007 Follow-up duration

Gallagher, R. (30) 2009 Follow-up duration

Geyer S. (31) 2006 Follow-up duration

Grandi S. (32) 2002 Follow-up duration

Grap M.J. (33) 1996 Follow-up duration

Gunnarsdottir T.J. (34) 2006 Follow-up duration

Hart R.R. (35) 2008 Follow-up duration

Hartford K. (36) 2002 Follow-up duration

Hata, M. (37) 2006 Follow-up duration

Hattan J. (38) 2002 Follow-up duration

Horne, D. (39) 2013 Follow-up duration

Hudson I.N. (40) 1979 Follow-up duration

Hwang S.-L. (41) 1998 Follow-up duration

Ille, R. (42) 2006 Follow-up duration

Kalogianni, A. (43) 2016 Follow-up duration

Katznelson R. (44) 2008 Follow-up duration

Khajian Gelogahi, Z. (45) 2018 Follow-up duration

Koivula M. (46) 2001 Follow-up duration

Krannich, JH (47) 2007 Follow-up duration

Ku, SL (48) 2002 Follow-up duration

Kumar, A. (49) 2019 Follow-up duration

LaPier T.K. (50) 2006 Follow-up duration

Liao, H-Y (51) 2018 Follow-up duration

Mahler H.I.M. (52) 1999 Follow-up duration

3

Matsuishi, Y. (53) 2019 Follow-up duration

Moghimian, M. (54) 2019 Follow-up duration

Mousavi Malek, N. (55) 2018 Follow-up duration

Naber, D. (56) 1985 Follow-up duration

Nelson F.V. (57) 1998 Follow-up duration

Norozi K. (58) 2006 Follow-up duration

Oxlad M. (59) 2006 Follow-up duration

Pick B. (60) 1994 Follow-up duration

Pinna Pintor P. (61) 1992 Follow-up duration

Royse C. (62) 2007 Follow-up duration

Royse C. (63) 2003 Follow-up duration

Ruiz B.A. (64) 1992 Follow-up duration

Salmon P. (65) 1998 Follow-up duration

Savageau J.A. (66) 1982 Follow-up duration

Sendelbach S.E. (67) 2006 Follow-up duration

Shahmansouri, N. (68) 2013 Follow-up duration

Staveski, S.L. (69) 2018 Follow-up duration

Stengrevics S. (70) 1996 Follow-up duration

Tully, P.J. (71) 2008 Follow-up duration

Tully, P.J. (72) 2011 Follow-up duration

Van der Zee K.I. (73) 2001 Follow-up duration

Vingerhoets G. (74) 1995 Follow-up duration

Vingerhoets G. (75) 1995 Follow-up duration

Way P. (76) 2003 Follow-up duration

Williams, J.B. (77) 2013 Follow-up duration

Yildiz, T. (78) 2014 Follow-up duration

Yin, Y.Q. (79) 2007 Follow-up duration

4

Zhang, C.Y. (80) 2012 Follow-up duration

Amaravathi, E. (81) 2018 Interventional study

Bass, C. (82) 1987 Interventional study

Bay, P. S. (83) 2008 Interventional study

Colella,T. J. F. (84) 2018 Interventional study

Dao, T. K. (85) 2011 Interventional study

Doering, L.V. (86) 2013 Interventional study

Dougherty, C.M. (87) 2004 Interventional study

Dunbar, S.B. (88) 2009 Interventional study

Engblom, E. (89) 1992 Interventional study

Engblom, E. (90) 1997 Interventional study

Kohn, C.S. (91) 2000 Interventional study

Lie, I. (92) 2007 Interventional study

Moazen-Zadeh, E. (93) 2018 Interventional study

Parent, N. (94) 2000 Interventional study

Relbo Authen, A. (95) 2017 Interventional study

Sharif, F. (96) 2012 Interventional study

Sørlie, T. (97) 2007 Interventional study

Stein, T.R. (98) 2010 Interventional study

Szalma, I. (99) 2006 Interventional study

Zarea, K. (100) 2014 Interventional study

Jones, E. R., Jr. (101) 1991 Letter

Kawada T. (102) 2016 Letter

Magni, G. (103) 1988 Letter

Abbasi M. (104) 2016 Missing baseline assessment

Abbasi, S.H. (105) 2015 Missing baseline assessment

Abbaszadeh, Y. (106) 2018 Missing baseline assessment

5

Ai, A.L. (107) 2014 Missing baseline assessment

Ai, A.L. (108) 1997 Missing baseline assessment

Ai, A.L. (109) 1997 Missing baseline assessment

Andrew, M.J. (110) 2000 Missing baseline assessment

Barrie, K. (111) 2019 Missing baseline assessment

Berg S.K. (112) 2016 Missing baseline assessment

Bohachick, P. (113) 2002 Missing baseline assessment

Brocks, Y. (114) 2017 Missing baseline assessment

Buendía, F. (115) 2011 Missing baseline assessment

Caruana, N. (116) 2018 Missing baseline assessment

Christensen, S. B. (117) 2012 Missing baseline assessment

Connerney, I. (118) 2010 Missing baseline assessment

Conway, A. (119) 2017 Missing baseline assessment

Conway, A. (120) 2016 Missing baseline assessment

Conway, A. (121) 2016 Missing baseline assessment

Detroyer, E. (122) 2008 Missing baseline assessment

Dew, M. A. (123) 2004 Missing baseline assessment

Dew, M. A. (124) 2001 Missing baseline assessment

Dew, M. A. (125) 2001 Missing baseline assessment

Dew, M. A. (126) 2000 Missing baseline assessment

Dew, M. A. (127) 1996 Missing baseline assessment

Donohue, JM. (128) 2014 Missing baseline assessment

Dougherty, C.M. (129) 2016 Missing baseline assessment

Fiabane, E. (130) 2014 Missing baseline assessment

Ford, J. (131) 2016 Missing baseline assessment

Foss-Nieradko, B. (132) 2012 Missing baseline assessment

Fredericks, S. (133) 2008 Missing baseline assessment

6

Freedland, K. (134) 2009 Missing baseline assessment

Fusar-Poli, P. (135) 2005 Missing baseline assessment

Gravely-Witte, S. (136) 2007 Missing baseline assessment

Gražulytė, D. (137) 2019 Missing baseline assessment

Hata, M. (138) 2011 Missing baseline assessment

Herbeck Belnap, B. (139) 2015 Missing baseline assessment

Isaksen K. (140) 2016 Missing baseline assessment

Karapolat, H. (141) 2013 Missing baseline assessment

Kok, L. (142) 2018 Missing baseline assessment

Kiliç, H.S. (143) 2018 Missing baseline assessment

Kugler, C. (144) 2013 Missing baseline assessment

Kugler, C. (145) 2012 Missing baseline assessment

Ladwig, K. H. (146) 2008 Missing baseline assessment

Líndal, E. (147) 1996 Missing baseline assessment

Meyer, T. (148) 2014 Missing baseline assessment

Miglioretti, M. (149) 2018 Missing baseline assessment

Morone, N.E. (150) 2010 Missing baseline assessment

Murphy, B.M. (151) 2012 Missing baseline assessment

Newman, S. (152) 1989 Missing baseline assessment

Nowicka-Sauer K. (153) 2016 Missing baseline assessment

Omodeo, O. (154) 2013 Missing baseline assessment

Oxlad, M. (155) 2008 Missing baseline assessment

Patron, E. (156) 2012 Missing baseline assessment

Patron, E. (157) 2013 Missing baseline assessment

Rafanelli, C. (158) 2006 Missing baseline assessment

Richards, K. (159) 2016 Missing baseline assessment

Roberts, C.R. (160) 2016 Missing baseline assessment

7

Rosenbloom, J.I. (161) 2009 Missing baseline assessment

Rossi, A. (162) 2011 Missing baseline assessment

Saeidi, M. (163) 2018 Missing baseline assessment

Schelling, G. (164) 2004 Missing baseline assessment

Sears, S. (165) 2007 Missing baseline assessment

Serber, E.R. (166) 2016 Missing baseline assessment

Shamaskin, A. M. (167) 2012 Missing baseline assessment

Stonnington, C. M. (168) 2016 Missing baseline assessment

Szczepanska-Gieracha, J. (169) 2012 Missing baseline assessment

Tindle, H. (170) 2012 Missing baseline assessment

Toren, P. (171) 2007 Missing baseline assessment

Tully, P.J. (172) 2016 Missing baseline assessment

Tung, H.H. (173) 2008 Missing baseline assessment

Vingerhoets, G. (174) 1998 Missing baseline assessment

Weerahandi, H. (175) 2017 Missing baseline assessment

Weis, F. (176) 2006 Missing baseline assessment

Yardley, M. (177) 2017 Missing baseline assessment

Baron, S.J. (178) 2017 No data to extract

Bhudia, S.K. (179) 2006 No data to extract

Chacko, R. C. (180) 1996 No data to extract

Chocron, S. (181) 2013 No data to extract

Contrada, R.J. (182) 2006 No data to extract

Deshields, T. L. (183) 1997 No data to extract

Doering L.V. (184) 2007 No data to extract

Dunkel, A. (185) 2011 No data to extract

Evangelista, L. S. (186) 2005 No data to extract

Folks, D.G. (187) 1986 No data to extract

8

Freeman, A.M. 3rd (188) 1988 No data to extract

Freeman, A.M. 3rd (189) 1986 No data to extract

Furze, G. (190) 2008 No data to extract

Gulielmos, V. (191) 1999 No data to extract

Holmes, S.D. (192) 2016 No data to extract

House, R. M. (193) 1988 No data to extract

Juergens, M.C. (194) 2010 No data to extract

Kendel, F. (195) 2010 No data to extract

Kuhn, W. F. (196) 1988 No data to extract

Langenbach, M. (197) 2006 No data to extract

Leszczynska, K. (198) 2004 No data to extract

Loghmani, L. (199) 2018 No data to extract

Mallik, S. (200) 2008 No data to extract

Mallik, S. (201) 2005 No data to extract

Mayou, R. (202) 1987 No data to extract

Nguyen, Q. (203) 2018 No data to extract

Nijs, K. (204) 2017 No data to extract

Packiasabapathy, S. (205) 2019 No data to extract

Selnes, O.A. (206) 2004 No data to extract

Sendelbach, S. (207) 2006 No data to extract

Serrano-Ikkos E. (208) 1999 No data to extract

Shuldham, C.M. (209) 2002 No data to extract

Smith, P.L.C. (210) 1986 No data to extract

Sokol, R.S. (211) 1987 No data to extract

Strouse, T. B. (212) 1996 No data to extract

Székely, A. (213) 2007 No data to extract

Tajbakhsh, F. (214) 2018 No data to extract

9

Tully, P.J. (215) 2009 No data to extract

Edéll-Gustafsson, U.M. (216) 1997 Study design

Afridi, M.I. (217) 2016 Study design

Amiaz, R. (218) 2016 Study design

Baranyi, A. (219) 2013 Study design

Bhavsar, R. (220) 2018 Study design

Blakeman, B.M. (221) 1987 Study design

Bluvstein, I. (222) 2013 Study design

Borregaard, B. (223) 2017 Study design

Bunz, M. (224) 2016 Study design

Bunzel, B. (225) 2008 Study design

Bunzel, B. (226) 2007 Study design

Bunzel, B. (227) 2005 Study design

Burg, M.M. (228) 2003 Study design

Burker, E. J. (229) 2005 Study design

Campbell, B. (230) 1999 Study design

Carney, R.M. (231) 1988 Study design

Chacko, R. C. (232) 1996 Study design

Chou, Y. Y. (233) 2017 Study design

Closs, S.J. (234) 2001 Study design

Collins, S.M. (235) 2002 Study design

Contrada, R.J. (236) 2008 Study design

Cserép, Z. (237) 2012 Study design

Czajkowski, S.M. (238) 1997 Study design

Curcio, N. (239) 2018 Study design

Dao, T.K. (240) 2010 Study design

Dehghani, H. (241) 2016 Study design

10

Deng, M.C. (242) 1995 Study design

Diegeler, A. (243) 1995 Study design

Doering, L.V. (244) 2007 Study design

Eisenberg, E. (245) 2001 Study design

Fitzsimons, D. (246) 2003 Study design

Freeman III, A.M. (247) 1984 Study design

Gallo, L.C. (248) 2005 Study design

Garbossa, A. (249) 2009 Study design

Ghosh, P. (250) 2003 Study design

Gierat-Haponiuk, K. (251) 2011 Study design

Gostoli, S. (252) 2016 Study design

Grønset, C.N. (253) 2019 Study design

Hauer, D. (254) 2013 Study design

Hazavei, S.M. (255) 2012 Study design

Heilmann, C. (256) 2012 Study design

Heilmann, C. (257) 2011 Study design

Herlitz, J. (258) 1998 Study design

Ho, P.M. (259) 2005 Study design

Hudetz, J.A. (260) 2010 Study design

Humphreys, N.K. (261) 2016 Study design

Immer, F.F. (262) 2003 Study design

İyigün, T. (263) 2017 Study design

Kadoi, Y. (264) 2011 Study design

Kallis, P. (265) 1993 Study design

Katznelson, R. (266) 2014 Study design

Kidd, T. (267) 2014 Study design

Koivula, M. (268) 2010 Study design

11

Koivula, M. (269) 2010 Study design

Koivula, M. (270) 2002 Study design

Kok, L. (271) 2016 Study design

Kok, L. (272) 2016 Study design

Kollner, V. (273) 2002 Study design

Kurlansky, P.A. (274) 2003 Study design

Lavdaniti, M. (275) 2015 Study design

Maricle, R. A. (276) 1989 Study design

Mastenbroek, M.H. (277) 2016 Study design

McCormick, K.M. (278) 2006 Study design

Miller, J.L. (279) 2016 Study design

Modica, M. (280) 2014 Study design

Murphy, B.M. (281) 2008 Study design

Murphy, B. (282) 2013 Study design

Okamoto, Y. (283) 2013 Study design

Oxlad, M. (284) 2006 Study design

Pérez-San-Gregorio, M. A. (285) 2003 Study design

Perski, A. (286) 1999 Study design

Plach, S.K. (287) 2003 Study design

Poole, L. (288) 2014 Study design

Poole, L. (289) 2013 Study design

Rahmawati, A. (290) 2016 Study design

Redeker, N.S. (291) 1993 Study design

Rezaei, O. (292) 2013 Study design

Rideout, A. (293) 2012 Study design

Rodrigues, H.F. (294) 2018 Study design

Rollman, B.L. (295) 2011 Study design

12

Sawatari, H. (296) 2016 Study design

Sears Jr, S. F. (297) 1995 Study design

Sedrakyan, A. (298) 2003 Study design

Shalaby, A.A. (299) 2014 Study design

Singh Solorzano, C. (300) 2019 Study design

Sirri, L. (301) 2011 Study design

Stenman, M. (302) 2014 Study design

Strauss, B. (303) 1992 Study design

Stoll, C. (304) 2000 Study design

Tully, P.J. (305) 2011 Study design

Tully, P.J. (306) 2015 Study design

Utriyaprasit, K. (307) 2005 Study design

Versteeg, H. (308) 2016 Study design

Viars, J. (309) 2009 Study design

Vitinius, F. (310) 2019 Study design

Voss, J.A. (311) 2004 Study design

Wellenius, G.A. (312) 2008 Study design

Young, Q. R. (313) 2007 Study design

Yüksel, V. (314) 2016 Study design

Zipfel, S. (315) 2002 Study design

Aguayo, E. (316) 2019 No depression/anxiety scale

Al-Ruzzeh, S. (317) 2004 No depression/anxiety scale

Albes, J.M. (318) 1991 No depression/anxiety scale

Althof, S.E. (319) 1984 No depression/anxiety scale

Anthony, S. J. (320) 2009 No depression/anxiety scale

Antiel, R.M. (321) 2016 No depression/anxiety scale

Arciniegas, E. (322) 1981 No depression/anxiety scale

13

Aydin, S. (323) 2006 No depression/anxiety scale

Baba, A. (324) 2006 No depression/anxiety scale

Baldassarre, F.G. (325) 2002 No depression/anxiety scale

Barr, M. L. (326) 2003 No depression/anxiety scale

Barry, L.C. (327) 2006 No depression/anxiety scale

Benke, K. (328) 2017 No depression/anxiety scale

Berg, A. (329) 2006 No depression/anxiety scale

Biglioli, P. (330) 2000 No depression/anxiety scale

Bjørnnes, A.K. (331) 2018 No depression/anxiety scale

Bonaros, N. (332) 2009 No depression/anxiety scale

Booth, D.C. (333) 1991 No depression/anxiety scale

Brorsson, B. (334) 1997 No depression/anxiety scale

Bruce, E.H. (335) 1983 No depression/anxiety scale

Bunzel, B. (336) 1989 No depression/anxiety scale

Bute, B.P. (337) 2003 No depression/anxiety scale

Caine, N. (338) 1991 No depression/anxiety scale

Casey, F.A. (339) 1996 No depression/anxiety scale

CASS Principal Investigators and Their

Associates (340) 1983 No depression/anxiety scale

Channer, K.S. (341) 1988 No depression/anxiety scale

Chocron, S. (342) 1996 No depression/anxiety scale

Chocron, S. (343) 1996 No depression/anxiety scale

Colak, Z. (344) 2008 No depression/anxiety scale

Covinsky, K.E. (345) 2008 No depression/anxiety scale

Damgaard, S. (346) 2011 No depression/anxiety scale

de Caprio, L. (347) 1980 No depression/anxiety scale

Deschka, H. (348) 2016 No depression/anxiety scale

14

Doering, L.V. (349) 2005 No depression/anxiety scale

Eichler, S. (350) 2016 No depression/anxiety scale

Elefteriades, J.A. (351) 1993 No depression/anxiety scale

Elliott, D. (352) 2006 No depression/anxiety scale

Elliott, D. (353) 2006 No depression/anxiety scale

Elliott, P.C. (354) 2010 No depression/anxiety scale

Falcoz, P.E. (355) 2002 No depression/anxiety scale

Fitzgerald, T.E. (356) 1993 No depression/anxiety scale

Folks, D.G. (357) 1988 No depression/anxiety scale

Fortunato de Cano, S. (358) 2016 No depression/anxiety scale

Frye, R.L. (359) 1997 No depression/anxiety scale

Gjeilo, K.H. (360) 2008 No depression/anxiety scale

Gold, J.P. (361) 1995 No depression/anxiety scale

Goldmann, L. (362) 1987 No depression/anxiety scale

Goldsmith, I. (363) 1999 No depression/anxiety scale

Grady, K.L. (364) 2011 No depression/anxiety scale

Guadagnoli, E. (365) 1992 No depression/anxiety scale

Guadagnoli, E. (366) 1995 No depression/anxiety scale

Gundle, M.J. (367) 1980 No depression/anxiety scale

Gupta, B.P. (368) 2016 No depression/anxiety scale

Hellgren, L. (369) 2005 No depression/anxiety scale

Herlitz, J. (370) 1998 No depression/anxiety scale

Herlitz, J. (371) 2003 No depression/anxiety scale

Herlitz, J. (372) 2005 No depression/anxiety scale

Herlitz, J. (373) 2000 No depression/anxiety scale

Herlitz, J. (374) 1997 No depression/anxiety scale

Herlitz, J. (375) 1999 No depression/anxiety scale

15

Herlitz, J. (376) 2000 No depression/anxiety scale

Hlatky, M.A. (377) 1997 No depression/anxiety scale

Ho, P.M. (378) 2005 No depression/anxiety scale

Hogue, C.W. (379) 2008 No depression/anxiety scale

Hokkanen, M. (380) 2014 No depression/anxiety scale

Horgan, D. (381) 1984 No depression/anxiety scale

Huysmans, H.A. (382) 1989 No depression/anxiety scale

Jaarsma, T. (383) 1997 No depression/anxiety scale

Järvinen, O. (384) 2004 No depression/anxiety scale

Järvinen, O. (385) 2005 No depression/anxiety scale

Järvinen, O. (386) 2007 No depression/anxiety scale

Järvinen, O. (387) 2003 No depression/anxiety scale

Järvinen, O. (388) 2004 No depression/anxiety scale

Jenkins, C.D. (389) 1990 No depression/anxiety scale

Jenkins, C.D. (390) 1994 No depression/anxiety scale

Jensen, B.Ø. (391) 2006 No depression/anxiety scale

Jidéus, L. (392) 2008 No depression/anxiety scale

Jolly, K. (393) 2003 No depression/anxiety scale

Jolly, K. (394) 2007 No depression/anxiety scale

Joshibayev, S. (395) 2016 No depression/anxiety scale

Juolasmaa, A. (396) 1981 No depression/anxiety scale

Kalkman, C.J. (397) 2003 No depression/anxiety scale

Kapetanakis, E.I. (398) 2008 No depression/anxiety scale

Karlsson, I. (399) 1999 No depression/anxiety scale

Karlsson, I. (400) 2000 No depression/anxiety scale

Kattainen, E. (401) 2006 No depression/anxiety scale

Kattainen, E. (402) 2005 No depression/anxiety scale

16

Keresztes, P. (403) 2003 No depression/anxiety scale

Kiebzak, G.M. (404) 2002 No depression/anxiety scale

King III S.B. (405) 1994 No depression/anxiety scale

King III S.B. (406) 1995 No depression/anxiety scale

Kleck, G. (407) 1984 No depression/anxiety scale

Klersy, C. (408) 1997 No depression/anxiety scale

Knipp, S.C. (409) 2004 No depression/anxiety scale

Koch, C.G. (410) 2008 No depression/anxiety scale

Koivunen, K. (411) 2007 No depression/anxiety scale

Kong, S.G. (412) 1986 No depression/anxiety scale

Krannich, J.H. (413) 2007 No depression/anxiety scale

Krucoff, M.W. (414) 2001 No depression/anxiety scale

Kuck, K.-H. (415) 2016 No depression/anxiety scale

Kulik, J.A. (416) 1993 No depression/anxiety scale

Le Grande, M.R. (417) 2006 No depression/anxiety scale

Lee, G.A. (418) 2009 No depression/anxiety scale

Lie, I. (419) 2010 No depression/anxiety scale

Lie, I. (420) 2009 No depression/anxiety scale

Líndal, E. (421) 1990 No depression/anxiety scale

Liou, H.L. (422) 2008 No depression/anxiety scale

Logeais, Y. (423) 1995 No depression/anxiety scale

Loponen, P. (424) 2007 No depression/anxiety scale

Lukkarinen, H. (425) 1998 No depression/anxiety scale

Magni, G. (426) 1987 No depression/anxiety scale

Manji, R.A. (427) 2017 No depression/anxiety scale

Markou, A.L. (428) 2007 No depression/anxiety scale

Markou, A.L. (429) 2008 No depression/anxiety scale

17

McCarthy, M.J. (430) 1995 No depression/anxiety scale

McCusker, C.G. (431) 2007 No depression/anxiety scale

McHugh, G.J. (432) 1997 No depression/anxiety scale

McKhann, G.M. (433) 2005 No depression/anxiety scale

Mealing, S. (434) 2016 No depression/anxiety scale

Meijboom, F. (435) 1994 No depression/anxiety scale

Menicanti, L. (436) 2002 No depression/anxiety scale

Michelsen, L.G. (437) 2003 No depression/anxiety scale

Miyamura, H. (438) 1996 No depression/anxiety scale

Mutch, W.A.C. (439) 2018 No depression/anxiety scale

Najafi, M. (440) 2009 No depression/anxiety scale

Najafi, M. (441) 2008 No depression/anxiety scale

Namerow, P.B. (442) 1999 No depression/anxiety scale

Newman, M.F. (443) 1995 No depression/anxiety scale

Nielsen, D. (444) 1997 No depression/anxiety scale

O'Rourke, A. (445) 1990 No depression/anxiety scale

Oelofsen, N. (446) 1998 No depression/anxiety scale

Olsson, M. (447) 1996 No depression/anxiety scale

Oxman, T.E. (448) 1994 No depression/anxiety scale

Pae, W.E. Jr. (449) 1987 No depression/anxiety scale

Peduzzi, P. (450) 1987 No depression/anxiety scale

Penckofer, S.H. (451) 1984 No depression/anxiety scale

Penckofer, S. (452) 2005 No depression/anxiety scale

Peovska, I. (453) 2008 No depression/anxiety scale

Peric, V. (454) 2008 No depression/anxiety scale

Peric, V.J. (455) 2010 No depression/anxiety scale

Peric, V.M. (456) 2006 No depression/anxiety scale

18

Perrotti, A. (457) 2016 No depression/anxiety scale

Pirraglia, P.A. (458) 2003 No depression/anxiety scale

Pocock, S.J. (459) 1996 No depression/anxiety scale

Poole, L. (460) 2017 No depression/anxiety scale

Pournaghash-Tehrani, S. (461) 2013 No depression/anxiety scale

Puskas, J.D. (462) 2004 No depression/anxiety scale

Ross, A.C. (463) 2001 No depression/anxiety scale

Ross, J.K. (464) 1981 No depression/anxiety scale

Rubens, F.D. (465) 2007 No depression/anxiety scale

Rumsfeld, J.S. (466) 2004 No depression/anxiety scale

Rumsfeld, J.S. (467) 2001 No depression/anxiety scale

Sadeghi, M. (468) 2017 No depression/anxiety scale

Saur, C.D. (469) 2001 No depression/anxiety scale

Savageau, J.A. (470) 1982 No depression/anxiety scale

Schulte, M.B. (471) 1990 No depression/anxiety scale

Schuuring, M.J. (472) 2016 No depression/anxiety scale

Shah, S.I. (473) 1994 No depression/anxiety scale

Shapira, O.M. (474) 1997 No depression/anxiety scale

Shaw, P.J. (475) 1985 No depression/anxiety scale

Shelley, M. (476) 2009 No depression/anxiety scale

Simchen, E. (477) 2001 No depression/anxiety scale

Singh, A. (478) 2017 No depression/anxiety scale

Sivertssen, E. (479) 1994 No depression/anxiety scale

Sjöland, H. (480) 1995 No depression/anxiety scale

Sjoland, H. (481) 1996 No depression/anxiety scale

Sjöland, H. (97) 1998 No depression/anxiety scale

Sjöland, H. (482) 1997 No depression/anxiety scale

19

Sjöland, H. (483) 1997 No depression/anxiety scale

Sjöland, H. (484) 1999 No depression/anxiety scale

Skaggs, B.G. (485) 1999 No depression/anxiety scale

Söderlind, K. (486) 1997 No depression/anxiety scale

Song, M.-K. (487) 2005 No depression/anxiety scale

Spadoti Dantas, RA. (488) 2008 No depression/anxiety scale

Speziale, G. (489) 1996 No depression/anxiety scale

Speziale, G. (490) 1996 No depression/anxiety scale

Sportelli, E. (491) 2016 No depression/anxiety scale

Steine, S. (492) 1996 No depression/anxiety scale

Stenman, M. (493) 2013 No depression/anxiety scale

Stenman, M. (494) 2015 No depression/anxiety scale

Stewart, A.B. (495) 1993 No depression/anxiety scale

Strauss, B. (496) 1992 No depression/anxiety scale

Strodl, E. (497) 2013 No depression/anxiety scale

Supino, P.G. (498) 2009 No depression/anxiety scale

Taillefer, M.C. (499) 2005 No depression/anxiety scale

Tatsuishi, W. (500) 2018 No depression/anxiety scale

Thomson Mangnall, L.J. (501) 2014 No depression/anxiety scale

Thylén, I. (502) 2016 No depression/anxiety scale

Toeg, H.D. (503) 2013 No depression/anxiety scale

Trouillet, J.L. (504) 1996 No depression/anxiety scale

Tsai, M.F. (505) 2019 No depression/anxiety scale

Tsai T.P. (506) 1994 No depression/anxiety scale

VA Coronary Artery Bypass Surgery

Cooperative Study Group (507) 1992 No depression/anxiety scale

Van Breugel, H.N. (508) 2010 No depression/anxiety scale

20

Van Dijk, D. (509) 2002 No depression/anxiety scale

Varaei, S. (510) 2017 No depression/anxiety scale

Vedio, B.A. (511) 2000 No depression/anxiety scale

Währborg, P. (512) 1999 No depression/anxiety scale

Weintraub, W.S. (513) 1995 No depression/anxiety scale

Welke, K.F. (514) 2003 No depression/anxiety scale

Westin, L. (515) 1999 No depression/anxiety scale

Westin, L. (516) 1997 No depression/anxiety scale

Wortman, P.M. (517) 1985 No depression/anxiety scale

Yardley, M. (518) 2018 No depression/anxiety scale

Yin, Q.Y. (519) 2012 No depression/anxiety scale

Ades, P.A. (520) 1992 Non cardiac surgery patients

Aida, N. (521) 2002 Non cardiac surgery patients

Beckie, T. (522) 1989 Non cardiac surgery patients

Ben-Noun, L. (523) 1999 Non cardiac surgery patients

Ben-Zur, H. (524) 2000 Non cardiac surgery patients

Benzer, W. (525) 2016 Non cardiac surgery patients

Black, J.L. (526) 1998 Non cardiac surgery patients

Brosig, C.L. (527) 2007 Non cardiac surgery patients

Brown, M.A. (528) 1993 Non cardiac surgery patients

Burns, J.W. (529) 2007 Non cardiac surgery patients

Caine, N. (530) 1996 Non cardiac surgery patients

Collins, J.A. (531) 1997 Non cardiac surgery patients

Crawford, I. (532) 2013 Non cardiac surgery patients

Dauerman, H.L. (533) 2000 Non cardiac surgery patients

Davies, N. (534) 2000 Non cardiac surgery patients

Denollet, J. (535) 2001 Non cardiac surgery patients

21

Dick, F. (536) 2008 Non cardiac surgery patients

Doerfler, L.A. (537) 1994 Non cardiac surgery patients

Douglas, P.S. (538) 2016 Non cardiac surgery patients

Dracup, K. (539) 1991 Non cardiac surgery patients

Du, C. (540) 2016 Non cardiac surgery patients

Dunkel, A. (541) 2009 Non cardiac surgery patients

Dunn, S.L. (542) 2006 Non cardiac surgery patients

Eales, C. (543) 1994 Non cardiac surgery patients

Foster, C. (544) 1995 Non cardiac surgery patients

Gabelhouse, J. (545) 2018 Non cardiac surgery patients

Gallagher, R. (546) 2003 Non cardiac surgery patients

Gross, C. R. (547) 2009 Non cardiac surgery patients

Halm, M.A. (548) 2007 Non cardiac surgery patients

Hämäläinen, H. (549) 2000 Non cardiac surgery patients

Hevey, D. (550) 2003 Non cardiac surgery patients

Hevey, D. (551) 2007 Non cardiac surgery patients

Hoehn, K.S. (552) 2004 Non cardiac surgery patients

Horsten, M. (553) 2000 Non cardiac surgery patients

Iliou, M.C. (554) 2016 Non cardiac surgery patients

Invernizzi, G. (555) 1991 Non cardiac surgery patients

Isgro, F. (556) 2002 Non cardiac surgery patients

Kobayashi, T. (557) 2011 Non cardiac surgery patients

Konttinen, M.P. (558) 1987 Non cardiac surgery patients

Kunadian, V. (559) 2016 Non cardiac surgery patients

Lauzon, C. (560) 2003 Non cardiac surgery patients

Lehto, S. (561) 2000 Non cardiac surgery patients

Lett, H.S. (562) 2006 Non cardiac surgery patients

22

Lichtenberger, C.M. (563) 2003 Non cardiac surgery patients

Maddox, T.M. (564) 2008 Non cardiac surgery patients

Marchlinski, F.E. (565) 2016 Non cardiac surgery patients

Mayou, R.A. (566) 2002 Non cardiac surgery patients

McKenna, K. (567) 2019 Non cardiac surgery patients

Milani, R.V. (568) 2007 Non cardiac surgery patients

Miller, S.P. (569) 1990 Non cardiac surgery patients

Moore, S.M. (570) 1995 Non cardiac surgery patients

Moser, D.K. (571) 1995 Non cardiac surgery patients

Moser, D.K. (572) 2010 Non cardiac surgery patients

Murphy, B.M. (573) 2008 Non cardiac surgery patients

Niset, G. (574) 1988 Non cardiac surgery patients

Norrman, S. (575) 2004 Non cardiac surgery patients

Oldenburg, B. (576) 1995 Non cardiac surgery patients

Panzaru, G.M. (577) 2015 Non cardiac surgery patients

Papadantonaki, A. (578) 1994 Non cardiac surgery patients

Pfiffner, D. (579) 2004 Non cardiac surgery patients

Poston, W.S. (580) 2003 Non cardiac surgery patients

Prudente, L.A. (581) 2006 Non cardiac surgery patients

Rankin, S.H. (582) 1990 Non cardiac surgery patients

Ruiz, J.M. (583) 2006 Non cardiac surgery patients

Schrader, G. (584) 2006 Non cardiac surgery patients

Sebregts, E.H. (585) 2005 Non cardiac surgery patients

Shiotani, I. (586) 2002 Non cardiac surgery patients

Simeone, S. (587) 2017 Non cardiac surgery patients

Sirois, B.C. (588) 2003 Non cardiac surgery patients

Söderman, E. (589) 2003 Non cardiac surgery patients

23

Söderman, E. (590) 2007 Non cardiac surgery patients

Son, H. (591) 2016 Non cardiac surgery patients

Spijkerman, T. (592) 2005 Non cardiac surgery patients

Sullivan, M.D. (593) 2003 Non cardiac surgery patients

Thomas, J.J. (594) 1995 Non cardiac surgery patients

Trzcieniecka-Green, A. (595) 1996 Non cardiac surgery patients

Trzcieniecka-Green, A. (596) 1994 Non cardiac surgery patients

Turner, S.C. (597) 2002 Non cardiac surgery patients

Turner, S.C. (598) 2003 Non cardiac surgery patients

Versteeg, T. (599) 2016 Non cardiac surgery patients

Wilcox, M.E. (600) 2016 Non cardiac surgery patients

Wray, J. (601) 2007 Non cardiac surgery patients

Xian, H. (602) 2010 Non cardiac surgery patients

Xiong, GL. (603) 2006 Non cardiac surgery patients

Yohannes, A.M. (604) 2007 Non cardiac surgery patients

Samadi, B. (605) 2019 Language other than English

Young, E. (606) 2005 Language other than English

AbuRuz, M.E. (607) 2019 Doubled population

Colella, T.J.F. (608) 2009 Doubled population

Pietrzyk, E. (609) 2014 Doubled population

Doering, L.V. (610) 2016 Doubled population

Duits, A.A. (611) 1998 Doubled population

Duits, A.A. (612) 2002 Doubled population

Heijmeriks, J. (613) 2000 Doubled population

Hwang, B. (614) 2015 Doubled population

Jones, B. M. (615) 1988 Doubled population

Sanchez, R. (616) 2015 Doubled population

24

Bando, K. (617) 2017 Editorial commentary

Al-Khatib, S.M. (618) 2016 Review

Fusar-Poli, P. (619) 2006 Review

Kidd, T. (620) 2016 Review

Mai, F. M. (621) 1987 Review

Michaelsen, K. (622) 2013 Review

Ng, C.Y. (623) 2016 Review

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