OBJECTIVE: Because it is not known whether particular clusters of depressive symptoms are associated with a greater risk of adverse cardiac outcomes, we compared the utility of four clusters in predicting incident coronary artery disease (CAD) events during a 15-year period in a large cohort of primary care patients 60 years and older. METHODS: Participants were 2537 primary care patients 60 years or older who were screened for depression between 1991 and 1993 and had no existing CAD diagnosis. Depressive symptoms cluster scores (depressed affect, somatic symptoms, interpersonal distress, and positive affect) were computed from responses on the Center for Epidemiologic Studies Depression Scale administered at baseline. CAD events, defined as the occurrence of a nonfatal acute myocardial infarction or CAD death during the follow-up period, were identified using electronic medical record and National Death Index data. RESULTS: There were 678 CAD events. In separate fully adjusted Cox proportional hazard models (controlling for demographics and cardiovascular risk factors), the depressed affect (hazard ratio [HR] = 1.11, 95% confidence interval [CI] = 1.04-1.20), somatic (HR = 1.17, 95% CI = 1.08-1.26), and positive affect (HR = 0.88, 95% CI = 0.82-0.95) clusters each predicted CAD events. When the depressive symptom clusters were entered simultaneously into the fully adjusted model, however, only the somatic cluster remained predictive of CAD events (HR = 1.13, 95% CI = 1.03-1.23). CONCLUSIONS: Our findings suggest that the longitudinal relationship between overall depressive symptom severity and incident CAD events may be driven primarily by the somatic cluster.
OBJECTIVE: Because it is not known whether particular clusters of depressive symptoms are associated with a greater risk of adverse cardiac outcomes, we compared the utility of four clusters in predicting incident coronary artery disease (CAD) events during a 15-year period in a large cohort of primary care patients 60 years and older. METHODS:Participants were 2537 primary care patients 60 years or older who were screened for depression between 1991 and 1993 and had no existing CAD diagnosis. Depressive symptoms cluster scores (depressed affect, somatic symptoms, interpersonal distress, and positive affect) were computed from responses on the Center for Epidemiologic Studies Depression Scale administered at baseline. CAD events, defined as the occurrence of a nonfatal acute myocardial infarction or CAD death during the follow-up period, were identified using electronic medical record and National Death Index data. RESULTS: There were 678 CAD events. In separate fully adjusted Cox proportional hazard models (controlling for demographics and cardiovascular risk factors), the depressed affect (hazard ratio [HR] = 1.11, 95% confidence interval [CI] = 1.04-1.20), somatic (HR = 1.17, 95% CI = 1.08-1.26), and positive affect (HR = 0.88, 95% CI = 0.82-0.95) clusters each predicted CAD events. When the depressive symptom clusters were entered simultaneously into the fully adjusted model, however, only the somatic cluster remained predictive of CAD events (HR = 1.13, 95% CI = 1.03-1.23). CONCLUSIONS: Our findings suggest that the longitudinal relationship between overall depressive symptom severity and incident CAD events may be driven primarily by the somatic cluster.
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Authors: Lisa Sm Eurelings; Jan Willem van Dalen; Gerben Ter Riet; Eric P Moll van Charante; Edo Richard; Willem A van Gool; Osvaldo P Almeida; Tiago S Alexandre; Bernhard T Baune; Horst Bickel; Francesco Cacciatore; Cyrus Cooper; Ton Ajm de Craen; Jean-Marie Degryse; Mauro Di Bari; Yeda A Duarte; Liang Feng; Nicola Ferrara; Leon Flicker; Maurizio Gallucci; Antonio Guaita; Stephanie L Harrison; Mindy J Katz; Maria L Lebrão; Jason Leung; Richard B Lipton; Marta Mengoni; Tze Pin Ng; Truls Østbye; Francesco Panza; Letizia Polito; Dirk Sander; Vincenzo Solfrizzi; Holly E Syddall; Roos C van der Mast; Bert Vaes; Jean Woo; Kristine Yaffe Journal: Clin Epidemiol Date: 2018-04-04 Impact factor: 4.790
Authors: Ashley S Emami; C Noel Bairey Merz; Jo-Ann Eastwood; Carl J Pepine; Eileen M Handberg; Vera Bittner; Puja K Mehta; David S Krantz; Viola Vaccarino; Wafia Eteiba; Carol E Cornell; Thomas Rutledge Journal: Heart Mind (Mumbai) Date: 2021-11-30