Eun Kyeung Song1, Debra K Moser2, Seok-Min Kang3, Terry A Lennie4. 1. University of Ulsan, College of Medicine, Department of Nursing, Ulsan, Korea. Electronic address: gracesong@ulsan.ac.kr. 2. University of Kentucky, College of Nursing, Lexington, KY, USA; University of Ulster, Newtownabbey, United Kingdom. 3. Severance Hospital, Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Seoul, Korea. 4. University of Kentucky, College of Nursing, Lexington, KY, USA.
Abstract
BACKGROUND: Depressive symptoms and malnutrition independently predict cardiac events in heart failure (HF) patients. However, the relationships among depressive symptoms, nutritional intake, and cardiac event-free survival have not been examined. METHODS AND RESULTS: A total of 232 patients with HF completed the Patient Health Questionnaire 9 (PHQ-9) to measure depressive symptoms and a 3-day food diary to determine the number of micronutrient deficiencies. Patients were followed for 2 years to collect data on cardiac event-free survival. Patients were divided into 4 groups by a PHQ-9 score of 10 and the median value of micronutrient deficiencies. Cox regressions were used to determine the relationships among depressive symptoms, micronutrient deficiency, and cardiac event-free survival. Depressive symptoms conferred greater risk of cardiac events in patients with a high number of micronutrient deficiencies than in those with a low number of micronutrient deficiencies. Patients with a PHQ-9 score ≥10 and number of micronutrient deficiencies >5 had 2.4 times higher risk for cardiac events compared with patients with a PHQ-9 score <10 and micronutrient deficiency ≤5 (P = .005). CONCLUSIONS: There was a synergistic effect on the association of depressive symptoms with cardiac event-free survival in HF patients that differed by micronutrient deficiency.
BACKGROUND:Depressive symptoms and malnutrition independently predict cardiac events in heart failure (HF) patients. However, the relationships among depressive symptoms, nutritional intake, and cardiac event-free survival have not been examined. METHODS AND RESULTS: A total of 232 patients with HF completed the Patient Health Questionnaire 9 (PHQ-9) to measure depressive symptoms and a 3-day food diary to determine the number of micronutrient deficiencies. Patients were followed for 2 years to collect data on cardiac event-free survival. Patients were divided into 4 groups by a PHQ-9 score of 10 and the median value of micronutrient deficiencies. Cox regressions were used to determine the relationships among depressive symptoms, micronutrient deficiency, and cardiac event-free survival. Depressive symptoms conferred greater risk of cardiac events in patients with a high number of micronutrient deficiencies than in those with a low number of micronutrient deficiencies. Patients with a PHQ-9 score ≥10 and number of micronutrient deficiencies >5 had 2.4 times higher risk for cardiac events compared with patients with a PHQ-9 score <10 and micronutrient deficiency ≤5 (P = .005). CONCLUSIONS: There was a synergistic effect on the association of depressive symptoms with cardiac event-free survival in HF patients that differed by micronutrient deficiency.
Authors: Debra K Moser; Cynthia Arslanian-Engoren; Martha J Biddle; Misook Lee Chung; Rebecca L Dekker; Muna H Hammash; Gia Mudd-Martin; Abdullah S Alhurani; Terry A Lennie Journal: Curr Cardiol Rep Date: 2016-12 Impact factor: 2.931
Authors: Scott L Hummel; Wahida Karmally; Brenda W Gillespie; Stephen Helmke; Sergio Teruya; Joanna Wells; Erika Trumble; Omar Jimenez; Cara Marolt; Jeffrey D Wessler; Maria L Cornellier; Mathew S Maurer Journal: Circ Heart Fail Date: 2018-08 Impact factor: 8.790
Authors: Barbara Riegel; Debra K Moser; Harleah G Buck; Victoria Vaughan Dickson; Sandra B Dunbar; Christopher S Lee; Terry A Lennie; JoAnn Lindenfeld; Judith E Mitchell; Diane J Treat-Jacobson; David E Webber Journal: J Am Heart Assoc Date: 2017-08-31 Impact factor: 5.501
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