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Predictive value of depression and anxiety for long-term mortality: differences in outcome between acute coronary syndrome and stable angina pectoris.
Int J Cardiol. 2018 Jan 01; 250:43-48.IJ

Abstract

BACKGROUND

Since the early 2000s the treatment of choice for an acute myocardial infarction has moved from thrombolytic therapy to primary PCI (pPCI). As a result, the majority of patients undergoing PCI shifted from stable angina pectoris (SA) to acute coronary syndrome (ACS). Additionally the previously observed association between depression and anxiety and long-term outcome in patients who underwent a PCI may have been changed. The main objective of this study was to investigate the predictive value of depression and anxiety for 10-year mortality, in a cohort with post-PCI patients treated for SA versus patients treated for ACS.

METHODS

This prospective single center cohort consists of a consecutive series of patients (n=528) treated with PCI. At 1month post-PCI, patients completed the Dutch version of the Hospital Anxiety and Depression Scale (HADS).

RESULTS

After adjustment for baseline characteristics depression was associated with higher 10-year mortality post-PCI (HR 1.58 95% Confidence Interval [95% CI] 1.04-2.40). In the ACS population no association between depression and 10-year mortality was found (HR 1.05 95% CI 0.62-1.79), in contrast to the SA population (HR 1.97 95% CI 1.09-3.57). After additional adjustment for anxiety, depression was no longer associated with higher mortality.

CONCLUSIONS

Anxiety at baseline was associated with an increased 10-year mortality rate after PCI. Depression was also associated with higher 10-year mortality, however the association disappeared after additional adjustment for anxiety. This finding was more pronounced in patients presenting with SA as compared to those presenting with ACS, which might be a result of the increasing number of ACS patients treated with pPCI.

Authors+Show Affiliations

Department of Cardiology, Thoraxcenter Erasmus Medical Centre, Rotterdam, The Netherlands.Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.Department of Cardiology, Thoraxcenter Erasmus Medical Centre, Rotterdam, The Netherlands.Department of Cardiology, Thoraxcenter Erasmus Medical Centre, Rotterdam, The Netherlands.Department of Cardiology, Thoraxcenter Erasmus Medical Centre, Rotterdam, The Netherlands.Department of Cardiology, Thoraxcenter Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: r.vandomburg@erasmusmc.nl.Department of Cardiology, Thoraxcenter Erasmus Medical Centre, Rotterdam, The Netherlands.Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands; Research Institute of Child Development and Education, University of Amsterdam/de Bascule-AMC, The Netherlands.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28992998

Citation

de Jager, Tom A J., et al. "Predictive Value of Depression and Anxiety for Long-term Mortality: Differences in Outcome Between Acute Coronary Syndrome and Stable Angina Pectoris." International Journal of Cardiology, vol. 250, 2018, pp. 43-48.
de Jager TAJ, Dulfer K, Radhoe S, et al. Predictive value of depression and anxiety for long-term mortality: differences in outcome between acute coronary syndrome and stable angina pectoris. Int J Cardiol. 2018;250:43-48.
de Jager, T. A. J., Dulfer, K., Radhoe, S., Bergmann, M. J., Daemen, J., van Domburg, R. T., Lenzen, M. J., & Utens, E. M. W. J. (2018). Predictive value of depression and anxiety for long-term mortality: differences in outcome between acute coronary syndrome and stable angina pectoris. International Journal of Cardiology, 250, 43-48. https://doi.org/10.1016/j.ijcard.2017.10.005
de Jager TAJ, et al. Predictive Value of Depression and Anxiety for Long-term Mortality: Differences in Outcome Between Acute Coronary Syndrome and Stable Angina Pectoris. Int J Cardiol. 2018 Jan 1;250:43-48. PubMed PMID: 28992998.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictive value of depression and anxiety for long-term mortality: differences in outcome between acute coronary syndrome and stable angina pectoris. AU - de Jager,Tom A J, AU - Dulfer,Karolijn, AU - Radhoe,Sumant, AU - Bergmann,Michael J, AU - Daemen,Joost, AU - van Domburg,Ron T, AU - Lenzen,Mattie J, AU - Utens,Elisabeth M W J, Y1 - 2017/10/06/ PY - 2017/03/07/received PY - 2017/09/05/revised PY - 2017/10/02/accepted PY - 2017/10/11/pubmed PY - 2018/7/14/medline PY - 2017/10/11/entrez KW - All-cause mortality KW - Anxiety KW - Depression KW - Percutaneous coronary intervention SP - 43 EP - 48 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 250 N2 - BACKGROUND: Since the early 2000s the treatment of choice for an acute myocardial infarction has moved from thrombolytic therapy to primary PCI (pPCI). As a result, the majority of patients undergoing PCI shifted from stable angina pectoris (SA) to acute coronary syndrome (ACS). Additionally the previously observed association between depression and anxiety and long-term outcome in patients who underwent a PCI may have been changed. The main objective of this study was to investigate the predictive value of depression and anxiety for 10-year mortality, in a cohort with post-PCI patients treated for SA versus patients treated for ACS. METHODS: This prospective single center cohort consists of a consecutive series of patients (n=528) treated with PCI. At 1month post-PCI, patients completed the Dutch version of the Hospital Anxiety and Depression Scale (HADS). RESULTS: After adjustment for baseline characteristics depression was associated with higher 10-year mortality post-PCI (HR 1.58 95% Confidence Interval [95% CI] 1.04-2.40). In the ACS population no association between depression and 10-year mortality was found (HR 1.05 95% CI 0.62-1.79), in contrast to the SA population (HR 1.97 95% CI 1.09-3.57). After additional adjustment for anxiety, depression was no longer associated with higher mortality. CONCLUSIONS: Anxiety at baseline was associated with an increased 10-year mortality rate after PCI. Depression was also associated with higher 10-year mortality, however the association disappeared after additional adjustment for anxiety. This finding was more pronounced in patients presenting with SA as compared to those presenting with ACS, which might be a result of the increasing number of ACS patients treated with pPCI. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/28992998/Predictive_value_of_depression_and_anxiety_for_long_term_mortality:_differences_in_outcome_between_acute_coronary_syndrome_and_stable_angina_pectoris_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(17)31511-5 DB - PRIME DP - Unbound Medicine ER -