Sex and gender in depression after percutaneous coronary intervention: clinical patterns, mechanistic hypotheses, and care pathways.
- 1Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
- 2Zhejiang Key Laboratory of Blood-Stasis-Toxin Syndrome, School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
- 3Zhejiang Engineering Research Center for "Preventive Treatment" Smart Health of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
Abstract
Depressive symptoms are common after percutaneous coronary intervention (PCI) and are associated with poorer recovery, lower adherence to secondary prevention, reduced participation in cardiac rehabilitation, and a higher risk of adverse cardiovascular outcomes. Evidence also suggests that depression after PCI is not experienced, detected, or managed in the same way across sex and gender groups. Women are more often reported to have higher early symptom scores, greater anxiety comorbidity, more somatic symptom overlap, and lower access to some forms of guideline-based cardiovascular care. Men may be less likely to disclose affective symptoms and may present psychological distress through externalizing behaviors, treatment disengagement, smoking, alcohol use, anger, or delayed help-seeking. These patterns should not be interpreted as fixed male-female traits. Rather, they probably reflect interactions among biological sex-related factors, social gender norms, comorbidity, age, socioeconomic position, and healthcare access. Unlike previous reviews that pool depression across coronary syndromes, this review is organized around patients after PCI, explicitly distinguishes conclusions directly supported by post-PCI data from those extrapolated from broader coronary populations, and identifies the remaining extrapolations as research priorities. This narrative review summarizes clinical patterns of depression after PCI, discusses plausible biological and psychosocial mechanisms, and proposes a sex- and gender-informed care pathway for screening, referral, cardiac rehabilitation, and follow-up. The available literature supports a more cautious and individualized approach than a simple binary model: screening tools should be interpreted alongside clinical interview and behavioral indicators; rehabilitation should address practical barriers, stigma, caregiving burden, and functional goals; and future studies should report sex-disaggregated data while also measuring gender-related exposures.
Related
- Deep dynamic coronary roadmap guidance in percutaneous coronary intervention: a deep learning approach
- From coronary computed tomography angiography to the cath lab: computed tomography-guided percutaneous coronary intervention of a high-risk left anterior descending artery lesion
- The impact of the SYNTAX score on the incidence of in-hospital cardiac arrest in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a retrospective cohort study
- Achieved LDL-C Levels and Clinical Outcomes Following Percutaneous Coronary Intervention with Drug-Coated Balloons for De Novo Coronary Lesions
- Assessing Calcified Coronary Lesions to Guide Percutaneous Coronary Intervention: From Angiography to Intracoronary Imaging
BibTeX
@article{wang2026gender,
title = {{Sex and gender in depression after percutaneous coronary intervention: clinical patterns, mechanistic hypotheses, and care pathways.}},
author = {Jieyi Wang and Zhiting Yang and Yang Hu and Zehua Liu and Hao Wu and Yilei Kong and Aisong Zhu},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1952343},
url = {https://europepmc.org/article/MED/42909337},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sex and gender in depression after percutaneous coronary intervention: clinical patterns, mechanistic hypotheses, and care pathways.
AU - Jieyi Wang
AU - Zhiting Yang
AU - Yang Hu
AU - Zehua Liu
AU - Hao Wu
AU - Yilei Kong
AU - Aisong Zhu
PY - 2026
DA - 2026/10/07
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1952343
UR - https://europepmc.org/article/MED/42909337
AB - Depressive symptoms are common after percutaneous coronary intervention (PCI) and are associated with poorer recovery, lower adherence to secondary prevention, reduced participation in cardiac rehabilitation, and a higher risk of adverse cardiovascular outcomes. Evidence also suggests that depression after PCI is not experienced, detected, or managed in the same way across sex and gender groups. Women are more often reported to have higher early symptom scores, greater anxiety comorbidity, more somatic symptom overlap, and lower access to some forms of guideline-based cardiovascular care. Men may be less likely to disclose affective symptoms and may present psychological distress through externalizing behaviors, treatment disengagement, smoking, alcohol use, anger, or delayed help-seeking. These patterns should not be interpreted as fixed male-female traits. Rather, they probably reflect interactions among biological sex-related factors, social gender norms, comorbidity, age, socioeconomic position, and healthcare access. Unlike previous reviews that pool depression across coronary syndromes, this review is organized around patients after PCI, explicitly distinguishes conclusions directly supported by post-PCI data from those extrapolated from broader coronary populations, and identifies the remaining extrapolations as research priorities. This narrative review summarizes clinical patterns of depression after PCI, discusses plausible biological and psychosocial mechanisms, and proposes a sex- and gender-informed care pathway for screening, referral, cardiac rehabilitation, and follow-up. The available literature supports a more cautious and individualized approach than a simple binary model: screening tools should be interpreted alongside clinical interview and behavioral indicators; rehabilitation should address practical barriers, stigma, caregiving burden, and functional goals; and future studies should report sex-disaggregated data while also measuring gender-related exposures.
SN - 2296-2565
ER -