OBJECTIVES: Depression is associated with poor prognosis in patients with cardiovascular disease (CVD). We hypothesized that depressive symptoms at discharge from a cardiac rehabilitation program are associated with an increased risk of future CVD-related hospitalizations. METHODS: We examined 486 CVD patients (mean age=59.8±11.2) who enrolled in a comprehensive 3-month rehabilitation program and completed the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). At follow-up we evaluated the predictive value of depressive symptoms for CVD-related hospitalizations, controlling for sociodemographic factors, cardiovascular risk factors, and disease severity. RESULTS: During a mean follow-up of 41.5±15.6 months, 63 patients experienced a CVD-related hospitalization. The percentage of depressive patients (HADS-D≥8) decreased from 16.9% at rehabilitation entry to 10.7% at discharge. Depressive symptoms at discharge from rehabilitation were a significant predictor of outcome (HR 1.32, 95% CI 1.09-1.60; p=0.004). Patients with clinically relevant depressive symptoms at discharge had a 2.5-fold increased relative risk of poor cardiac prognosis compared to patients without clinically relevant depressive symptoms independently of other prognostic variables. CONCLUSION: In patients with CVD, depressive symptoms at discharge from rehabilitation indicated a poor cardiac prognosis.
OBJECTIVES:Depression is associated with poor prognosis in patients with cardiovascular disease (CVD). We hypothesized that depressive symptoms at discharge from a cardiac rehabilitation program are associated with an increased risk of future CVD-related hospitalizations. METHODS: We examined 486 CVD patients (mean age=59.8±11.2) who enrolled in a comprehensive 3-month rehabilitation program and completed the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). At follow-up we evaluated the predictive value of depressive symptoms for CVD-related hospitalizations, controlling for sociodemographic factors, cardiovascular risk factors, and disease severity. RESULTS: During a mean follow-up of 41.5±15.6 months, 63 patients experienced a CVD-related hospitalization. The percentage of depressivepatients (HADS-D≥8) decreased from 16.9% at rehabilitation entry to 10.7% at discharge. Depressive symptoms at discharge from rehabilitation were a significant predictor of outcome (HR 1.32, 95% CI 1.09-1.60; p=0.004). Patients with clinically relevant depressive symptoms at discharge had a 2.5-fold increased relative risk of poor cardiac prognosis compared to patients without clinically relevant depressive symptoms independently of other prognostic variables. CONCLUSION: In patients with CVD, depressive symptoms at discharge from rehabilitation indicated a poor cardiac prognosis.
Authors: Jennifer Sanner; Megan L Grove; Erica Yu; F Gerard Moeller; Stanley G Cron; Eric Boerwinkle; Alanna C Morrison; Lorraine Frazier Journal: Biol Res Nurs Date: 2018-01-03 Impact factor: 2.522
Authors: Felipe José Nascimento Barreto; Frederico Duarte Garcia; Paulo Henrique Teixeira Prado; Paulo Marcos Brasil Rocha; Nádia Souza Las Casas; Felipe Barbosa Vallt; Humberto Correa; Maila Castro Lourenço Neves Journal: World J Psychiatry Date: 2017-06-22