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Transient impact of baseline depression on mortality in patients with stable coronary heart disease during long-term follow-up.
Clin Res Cardiol. 2014 May; 103(5):389-95.CR

Abstract

OBJECTIVE

The objective of this prospective study was to determine the impact of depressive symptoms on long-term survival in coronary heart disease (CHD) patients treated with intracoronary stenting.

METHODS

Four hundred and seventy patients completed the Hospital Anxiety and Depression Scale (HADS) before undergoing stent implantation and were followed over a 5-year period. Survival data were collected from n = 462 participants (98.3 %). A cut-off ≥8 on the HADS depression subscale was used to indicate probable clinical levels of depression.

RESULTS

All-cause mortality rates differed significantly between depressed and non-depressed patients at 2-year follow-up, as 6 out of 98 subjects with elevated HADS-D scores (6.1 %), but only 8 out of 364 (2.2 %) patients with normal HADS-D scores had died [odds ratio = 2.9, 95 % confidence interval (95 % CI) = 1.0-8.6, p = 0.044]. In a Cox regression model adjusted for sociodemographic and clinical parameters, positive HADS-D scores [hazard ratio (HR) = 4.3, 95 % CI = 1.2-15.4, p = 0.025], body-mass index (HR = 0.8, 95 % CI = 0.7-1.0, p = 0.040) and stent length (HR = 1.1, 95 % CI = 1.0-1.1, p = 0.042) independently predicted 2-year survival. From the third to the fifth year after index PCI, the frequency of deaths in the depressed patients' group did not significantly differ from that observed in non-depressed patients (5.5 % versus 7.0 %, p = 0.607), and the predictive role of baseline HADS-D scores for survival was lost.

CONCLUSION

In CHD patients, self-rated depressive symptoms at baseline were negatively linked to survival at 2-year follow-up, but failed to predict mortality 3 years later. Thus, in contrast to other well-established risk factors, the prognostic value of depression for predicting adverse outcome may be temporarily limited. The mechanisms behind this transient effect need further study.

Authors+Show Affiliations

Klinik für Psychosomatische Medizin und Psychotherapie, Deutsches Zentrum für Herz- und Kreislaufforschung, Universität Göttingen, von-Siebold-Str. 5, 37075, Göttingen, Germany, thomas.meyer@med.uni-goettingen.de.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24464107

Citation

Meyer, Thomas, et al. "Transient Impact of Baseline Depression On Mortality in Patients With Stable Coronary Heart Disease During Long-term Follow-up." Clinical Research in Cardiology : Official Journal of the German Cardiac Society, vol. 103, no. 5, 2014, pp. 389-95.
Meyer T, Hussein S, Lange HW, et al. Transient impact of baseline depression on mortality in patients with stable coronary heart disease during long-term follow-up. Clin Res Cardiol. 2014;103(5):389-95.
Meyer, T., Hussein, S., Lange, H. W., & Herrmann-Lingen, C. (2014). Transient impact of baseline depression on mortality in patients with stable coronary heart disease during long-term follow-up. Clinical Research in Cardiology : Official Journal of the German Cardiac Society, 103(5), 389-95. https://doi.org/10.1007/s00392-014-0666-6
Meyer T, et al. Transient Impact of Baseline Depression On Mortality in Patients With Stable Coronary Heart Disease During Long-term Follow-up. Clin Res Cardiol. 2014;103(5):389-95. PubMed PMID: 24464107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transient impact of baseline depression on mortality in patients with stable coronary heart disease during long-term follow-up. AU - Meyer,Thomas, AU - Hussein,Sharif, AU - Lange,Helmut W, AU - Herrmann-Lingen,Christoph, Y1 - 2014/01/24/ PY - 2013/10/01/received PY - 2014/01/09/accepted PY - 2014/1/28/entrez PY - 2014/1/28/pubmed PY - 2014/12/15/medline SP - 389 EP - 95 JF - Clinical research in cardiology : official journal of the German Cardiac Society JO - Clin Res Cardiol VL - 103 IS - 5 N2 - OBJECTIVE: The objective of this prospective study was to determine the impact of depressive symptoms on long-term survival in coronary heart disease (CHD) patients treated with intracoronary stenting. METHODS: Four hundred and seventy patients completed the Hospital Anxiety and Depression Scale (HADS) before undergoing stent implantation and were followed over a 5-year period. Survival data were collected from n = 462 participants (98.3 %). A cut-off ≥8 on the HADS depression subscale was used to indicate probable clinical levels of depression. RESULTS: All-cause mortality rates differed significantly between depressed and non-depressed patients at 2-year follow-up, as 6 out of 98 subjects with elevated HADS-D scores (6.1 %), but only 8 out of 364 (2.2 %) patients with normal HADS-D scores had died [odds ratio = 2.9, 95 % confidence interval (95 % CI) = 1.0-8.6, p = 0.044]. In a Cox regression model adjusted for sociodemographic and clinical parameters, positive HADS-D scores [hazard ratio (HR) = 4.3, 95 % CI = 1.2-15.4, p = 0.025], body-mass index (HR = 0.8, 95 % CI = 0.7-1.0, p = 0.040) and stent length (HR = 1.1, 95 % CI = 1.0-1.1, p = 0.042) independently predicted 2-year survival. From the third to the fifth year after index PCI, the frequency of deaths in the depressed patients' group did not significantly differ from that observed in non-depressed patients (5.5 % versus 7.0 %, p = 0.607), and the predictive role of baseline HADS-D scores for survival was lost. CONCLUSION: In CHD patients, self-rated depressive symptoms at baseline were negatively linked to survival at 2-year follow-up, but failed to predict mortality 3 years later. Thus, in contrast to other well-established risk factors, the prognostic value of depression for predicting adverse outcome may be temporarily limited. The mechanisms behind this transient effect need further study. SN - 1861-0692 UR - https://www.unboundmedicine.com/medline/citation/24464107/Transient_impact_of_baseline_depression_on_mortality_in_patients_with_stable_coronary_heart_disease_during_long_term_follow_up_ L2 - https://dx.doi.org/10.1007/s00392-014-0666-6 DB - PRIME DP - Unbound Medicine ER -