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Depression and anxiety symptoms as predictors of mortality in PCI patients at 10 years of follow-up.
Eur J Prev Cardiol. 2016 Mar; 23(5):552-8.EJ

Abstract

BACKGROUND

Depression has been shown to be an independent risk factor for short-term mortality in patients with coronary artery disease (CAD). There are studies suggesting that depression might also be associated with long-term mortality. Anxiety has also been associated with mortality. This study aimed to further investigate the predictive value of depression and anxiety symptoms on all-cause mortality, 10 years after percutaneous coronary intervention (PCI).

METHODS

The study population comprised a consecutive series of CAD patients (n = 1411) treated with PCI between September 2001 and October 2002 at the Erasmus Medical Centre, Rotterdam. The Hospital Anxiety and Depression Scale (HADS) was completed by 1112 patients at baseline to assess levels of depression and anxiety. The endpoint was defined as all-cause mortality.

RESULTS

The prevalence of depression and anxiety was 24.8% and 27.7%, respectively. The cumulative all-cause mortality rate in depressed patients was 37% versus 20% in non-depressed patients (log-rank p < 0.001). After adjustment, depression remained a predictor of all-cause mortality (hazard ratio (HR) 1.77; 95% confidence interval (CI) 1.36-2.29). Cumulative survival rates did not differ for anxious versus non-anxious patients (log-rank p = .79). However, after adjustment, anxiety was associated with an increased risk for all-cause mortality (HR 1.50; 95% CI 1.14-1.98). A sub-analysis showed that cumulative survival rates did not differ for depressed and anxious patients versus depressed but non-anxious patients (log-rank p = 0.46).

CONCLUSIONS

Depression is associated with an increased risk of 77% for all-cause mortality, 10 years post-PCI, independently of anxiety. Although anxiety was associated with all-cause mortality, it has no additional value in the case of co-occurring depression.

Authors+Show Affiliations

Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, The Netherlands.Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, The Netherlands.Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, The Netherlands.Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, The Netherlands.Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, The Netherlands.Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, The Netherlands.Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, The Netherlands r.vandomburg@erasmusmc.nl.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25665581

Citation

van Dijk, Milan R., et al. "Depression and Anxiety Symptoms as Predictors of Mortality in PCI Patients at 10 Years of Follow-up." European Journal of Preventive Cardiology, vol. 23, no. 5, 2016, pp. 552-8.
van Dijk MR, Utens EM, Dulfer K, et al. Depression and anxiety symptoms as predictors of mortality in PCI patients at 10 years of follow-up. Eur J Prev Cardiol. 2016;23(5):552-8.
van Dijk, M. R., Utens, E. M., Dulfer, K., Al-Qezweny, M. N., van Geuns, R. J., Daemen, J., & van Domburg, R. T. (2016). Depression and anxiety symptoms as predictors of mortality in PCI patients at 10 years of follow-up. European Journal of Preventive Cardiology, 23(5), 552-8. https://doi.org/10.1177/2047487315571889
van Dijk MR, et al. Depression and Anxiety Symptoms as Predictors of Mortality in PCI Patients at 10 Years of Follow-up. Eur J Prev Cardiol. 2016;23(5):552-8. PubMed PMID: 25665581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depression and anxiety symptoms as predictors of mortality in PCI patients at 10 years of follow-up. AU - van Dijk,Milan R, AU - Utens,Elisabeth M W J, AU - Dulfer,Karolijn, AU - Al-Qezweny,Mustafa N A, AU - van Geuns,Robert-Jan, AU - Daemen,Joost, AU - van Domburg,Ron T, Y1 - 2015/02/09/ PY - 2014/10/19/received PY - 2015/01/19/accepted PY - 2015/2/11/entrez PY - 2015/2/11/pubmed PY - 2016/12/15/medline KW - Depression KW - all-cause mortality KW - anxiety KW - coronary artery disease KW - percutaneous coronary intervention SP - 552 EP - 8 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 23 IS - 5 N2 - BACKGROUND: Depression has been shown to be an independent risk factor for short-term mortality in patients with coronary artery disease (CAD). There are studies suggesting that depression might also be associated with long-term mortality. Anxiety has also been associated with mortality. This study aimed to further investigate the predictive value of depression and anxiety symptoms on all-cause mortality, 10 years after percutaneous coronary intervention (PCI). METHODS: The study population comprised a consecutive series of CAD patients (n = 1411) treated with PCI between September 2001 and October 2002 at the Erasmus Medical Centre, Rotterdam. The Hospital Anxiety and Depression Scale (HADS) was completed by 1112 patients at baseline to assess levels of depression and anxiety. The endpoint was defined as all-cause mortality. RESULTS: The prevalence of depression and anxiety was 24.8% and 27.7%, respectively. The cumulative all-cause mortality rate in depressed patients was 37% versus 20% in non-depressed patients (log-rank p < 0.001). After adjustment, depression remained a predictor of all-cause mortality (hazard ratio (HR) 1.77; 95% confidence interval (CI) 1.36-2.29). Cumulative survival rates did not differ for anxious versus non-anxious patients (log-rank p = .79). However, after adjustment, anxiety was associated with an increased risk for all-cause mortality (HR 1.50; 95% CI 1.14-1.98). A sub-analysis showed that cumulative survival rates did not differ for depressed and anxious patients versus depressed but non-anxious patients (log-rank p = 0.46). CONCLUSIONS: Depression is associated with an increased risk of 77% for all-cause mortality, 10 years post-PCI, independently of anxiety. Although anxiety was associated with all-cause mortality, it has no additional value in the case of co-occurring depression. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/25665581/Depression_and_anxiety_symptoms_as_predictors_of_mortality_in_PCI_patients_at_10_years_of_follow_up_ L2 - http://journals.sagepub.com/doi/full/10.1177/2047487315571889?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -