Eun Kyeung Song1, Debra K Moser, Rebecca L Dekker, Terry A Lennie. 1. Eun Kyeung Song, PhD, RN Associate Professor, Department of Nursing, College of Medicine, University of Ulsan, South Korea. Debra K. Moser, DNSc, RN, FAAN Professor, College of Nursing, University of Kentucky, Lexington. Rebecca L. Dekker, PhD, APRN Assistant Professor, College of Nursing, University of Kentucky, Lexington. Terry A. Lennie, PhD, RN, FAAN Professor and Associate Dean, PhD Studies, College of Nursing, University of Kentucky, Lexington.
Abstract
BACKGROUND: Depressive symptoms are predictors of shorter cardiac event-free survival, whereas increased body mass index (BMI) is associated with longer cardiac event-free survival in patients with heart failure (HF). However, the impact of BMI on the link between depressive symptoms and cardiac event-free survival is unexplored. The purpose of this study was to determine whether the relationship between depressive symptoms and cardiac event-free survival differs among HF patients stratified by BMI tertiles. METHODS: A total of 297 outpatients with HF completed the Patient Health Questionnaire-9 to assess depressive symptoms. Body mass index was calculated as weight in kilograms divided by height in meters squared. Patients were followed for 1 year to determine cardiac event-free survival. Cox proportional hazard regression with survival curves was used to determine the relationships among depressive symptoms, BMI, and cardiac event-free survival. RESULTS: Both depressive symptoms (P < .001) and lower BMI (P = .002) are independent predictors of shorter cardiac event-free survival after controlling for age, gender, etiology, total comorbidity scores, ejection fraction, New York Heart Association functional class, and prescribed medications. Patients with depressive symptoms had shorter cardiac event-free survival compared with patients without depressive symptoms in the lowest (P = .001) and middle (P = .036) BMI tertiles. There was no difference in cardiac event-free survival between patients with and without depressive symptoms in the highest tertile (P = .894). CONCLUSIONS: Higher BMI has a protective role in the adverse effect of depressive symptoms on health outcomes in patients with HF.
BACKGROUND:Depressive symptoms are predictors of shorter cardiac event-free survival, whereas increased body mass index (BMI) is associated with longer cardiac event-free survival in patients with heart failure (HF). However, the impact of BMI on the link between depressive symptoms and cardiac event-free survival is unexplored. The purpose of this study was to determine whether the relationship between depressive symptoms and cardiac event-free survival differs among HF patients stratified by BMI tertiles. METHODS: A total of 297 outpatients with HF completed the Patient Health Questionnaire-9 to assess depressive symptoms. Body mass index was calculated as weight in kilograms divided by height in meters squared. Patients were followed for 1 year to determine cardiac event-free survival. Cox proportional hazard regression with survival curves was used to determine the relationships among depressive symptoms, BMI, and cardiac event-free survival. RESULTS: Both depressive symptoms (P < .001) and lower BMI (P = .002) are independent predictors of shorter cardiac event-free survival after controlling for age, gender, etiology, total comorbidity scores, ejection fraction, New York Heart Association functional class, and prescribed medications. Patients with depressive symptoms had shorter cardiac event-free survival compared with patients without depressive symptoms in the lowest (P = .001) and middle (P = .036) BMI tertiles. There was no difference in cardiac event-free survival between patients with and without depressive symptoms in the highest tertile (P = .894). CONCLUSIONS: Higher BMI has a protective role in the adverse effect of depressive symptoms on health outcomes in patients with HF.
Authors: Terry A Lennie; Christina Andreae; Mary Kay Rayens; Eun Kyeung Song; Sandra B Dunbar; Susan J Pressler; Seongkum Heo; JinShil Kim; Debra K Moser Journal: J Am Heart Assoc Date: 2018-09-04 Impact factor: 5.501