Tsuyoshi Suzuki1, Tsuyoshi Shiga2, Kazue Kuwahara3, Sayaka Kobayashi4, Shinichi Suzuki5, Katsuji Nishimura4, Atsushi Suzuki1, Yuichiro Minami1, Jun Ishigooka4, Hiroshi Kasanuki6, Nobuhisa Hagiwara1. 1. Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. 2. Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: mshiga@hij.twmu.ac.jp. 3. Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan; Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan. 4. Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan. 5. Faculty of Human Sciences, Waseda University, Tokorozawa, Japan. 6. Tokyo Women's Medical University, Tokyo, Japan.
Abstract
BACKGROUND: Anxiety is often present in patients with depression. The aim of this study was to evaluate the impact of clustered depression and anxiety on mortality and rehospitalization in hospitalized patients with heart failure (HF). METHODS: A total of 221 hospitalized patients with HF, who completed the questionnaires, were analyzed in this prospective study (mean age 62±13 years; 28% female). One-third patients had implanted cardiac devices. Depression was defined as a Zung Self-Rating Depression Scale index score of ≥60 and anxiety was defined as a State-Trait Anxiety Inventory score of ≥40 (male) or ≥42 (female). The primary outcome was the composite of death from any cause or rehospitalization due to worsened HF and refractory arrhythmia. RESULTS: Of the 221 HF patients, 29 (13%) had depression alone, 80 (36%) had anxiety alone, and 46 patients (21%) had both depression and anxiety. During an average follow-up of 41±21 months, patients with depression alone and those with clustered depression and anxiety were at an increased risk of the primary outcome [hazard ratio (HR) 2.24, 95% confidence interval (CI): 1.17-4.28, p=0.01 and HR 2.75, 95% CI: 1.51-4.99, p=0.01, respectively] compared to patients with no symptoms. Multivariate analysis after adjusting for age, gender, New York Heart Association functional class, B-type natriuretic peptide, device implantation, renal dysfunction, and left ventricular dysfunction showed clustered depression and anxiety, but not depression alone or anxiety alone, was an independent predictor of the primary outcome (HR 1.96, 95% CI: 1.00-3.27, p=0.04). CONCLUSIONS: Our results showed that clustered depression and anxiety were associated with worse outcomes in patients with HF.
BACKGROUND:Anxiety is often present in patients with depression. The aim of this study was to evaluate the impact of clustered depression and anxiety on mortality and rehospitalization in hospitalized patients with heart failure (HF). METHODS: A total of 221 hospitalized patients with HF, who completed the questionnaires, were analyzed in this prospective study (mean age 62±13 years; 28% female). One-third patients had implanted cardiac devices. Depression was defined as a Zung Self-Rating Depression Scale index score of ≥60 and anxiety was defined as a State-Trait Anxiety Inventory score of ≥40 (male) or ≥42 (female). The primary outcome was the composite of death from any cause or rehospitalization due to worsened HF and refractory arrhythmia. RESULTS: Of the 221 HF patients, 29 (13%) had depression alone, 80 (36%) had anxiety alone, and 46 patients (21%) had both depression and anxiety. During an average follow-up of 41±21 months, patients with depression alone and those with clustered depression and anxiety were at an increased risk of the primary outcome [hazard ratio (HR) 2.24, 95% confidence interval (CI): 1.17-4.28, p=0.01 and HR 2.75, 95% CI: 1.51-4.99, p=0.01, respectively] compared to patients with no symptoms. Multivariate analysis after adjusting for age, gender, New York Heart Association functional class, B-type natriuretic peptide, device implantation, renal dysfunction, and left ventricular dysfunction showed clustered depression and anxiety, but not depression alone or anxiety alone, was an independent predictor of the primary outcome (HR 1.96, 95% CI: 1.00-3.27, p=0.04). CONCLUSIONS: Our results showed that clustered depression and anxiety were associated with worse outcomes in patients with HF.
Authors: Christopher M Celano; Ana C Villegas; Ariana M Albanese; Hanna K Gaggin; Jeff C Huffman Journal: Harv Rev Psychiatry Date: 2018 Jul/Aug Impact factor: 3.732
Authors: Stephanie A Hooker; Kaile Ross; Kevin S Masters; Crystal L Park; Amy E Hale; Larry A Allen; David B Bekelman Journal: J Cardiovasc Nurs Date: 2017 May/Jun Impact factor: 2.083
Authors: Geri C Reeves; Abdullah S Alhurani; Susan K Frazier; John F Watkins; Terry A Lennie; Debra K Moser Journal: BMJ Open Diabetes Res Care Date: 2015-05-30
Authors: Crispino Tosto; Luigi Adamo; Heidi Craddock; Maria Di Blasi; Rosario Girgenti; Francesco Clemenza; Robert M Carney; Gregory Ewald Journal: Sci Rep Date: 2019-07-25 Impact factor: 4.379