Karl-Heinz Ladwig1, Jens Baumert2, Birgitt Marten-Mittag3, Karoline Lukaschek4, Hamimatunnisa Johar2, Xioayan Fang5, Joram Ronel3, Christa Meisinger2, Annette Peters6. 1. Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Partnersite Munich, Germany; Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: Ladwig@helmholtz-muenchen.de. 2. Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany. 3. Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 4. Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Department of Psychosomatic Medicine and Psychotherapy, University of Marburg and Gießen, Germany. 5. Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 6. Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Partnersite Munich, Germany.
Abstract
BACKGROUND AND AIMS: Depressed mood and exhaustion (DEEX) have gained attention as a risk predictor for cardiovascular disease (CVD). Studies to estimate its ranking in prediction models are sparse. METHODS: The study included 3428 men aged 45-74 years who participated in one of three population-based MONICA/KORA Augsburg surveys conducted between 1984 and 1995. Within a follow-up time of 10 years (31,791 person-years), 557 cases of all-cause mortality and 269 fatal CVD events were observed. Adjusted Cox proportional hazards models were used to assess mortality risks for DEEX and five classical cardiovascular risk factors. The predictive ability was evaluated by the area under the receiver-operating characteristic curve, the integrated discrimination improvement statistics and the net classification improvement. RESULTS: The (crude) absolute mortality risk for DEEX was 23.1 cases per 1000 person-years for all-cause and 11.2 for CVD mortality. The adjusted hazard ratios of 1.52 for all-cause and 1.52 for CVD mortality (p < 0.01) were higher than those for hypercholesterolemia and obesity, but lower than for hypertension, smoking and diabetes. The improvements in risk prediction from DEEX were comparable to those of hypercholesterolemia and obesity, but substantially lower than those of hypertension, smoking and diabetes. The adjusted population-attributable risk (PAR) for DEEX accounted for about 15% for all-cause and CVD mortality, which gives DEEX a middle ranking amongst the classical risk factors. CONCLUSIONS: DEEX is a strong predictor of mortality risk, ranking in a medium position amongst classical somatic risk factors.
BACKGROUND AND AIMS: Depressed mood and exhaustion (DEEX) have gained attention as a risk predictor for cardiovascular disease (CVD). Studies to estimate its ranking in prediction models are sparse. METHODS: The study included 3428 men aged 45-74 years who participated in one of three population-based MONICA/KORA Augsburg surveys conducted between 1984 and 1995. Within a follow-up time of 10 years (31,791 person-years), 557 cases of all-cause mortality and 269 fatal CVD events were observed. Adjusted Cox proportional hazards models were used to assess mortality risks for DEEX and five classical cardiovascular risk factors. The predictive ability was evaluated by the area under the receiver-operating characteristic curve, the integrated discrimination improvement statistics and the net classification improvement. RESULTS: The (crude) absolute mortality risk for DEEX was 23.1 cases per 1000 person-years for all-cause and 11.2 for CVD mortality. The adjusted hazard ratios of 1.52 for all-cause and 1.52 for CVD mortality (p < 0.01) were higher than those for hypercholesterolemia and obesity, but lower than for hypertension, smoking and diabetes. The improvements in risk prediction from DEEX were comparable to those of hypercholesterolemia and obesity, but substantially lower than those of hypertension, smoking and diabetes. The adjusted population-attributable risk (PAR) for DEEX accounted for about 15% for all-cause and CVD mortality, which gives DEEX a middle ranking amongst the classical risk factors. CONCLUSIONS: DEEX is a strong predictor of mortality risk, ranking in a medium position amongst classical somatic risk factors.
Authors: Miodrag Jovan Sreckovic; Nikola Jagic; Vladimir Miloradovic; Aleksandar Neskovic; Ivan Soldatovic; Ilija Srdanovic Journal: Postepy Kardiol Interwencyjnej Date: 2017-05-25 Impact factor: 1.426
Authors: Sascha Ketelhut; Emanuel Wehlan; Gerhart Bayer; Reinhard G Ketelhut Journal: Int J Environ Res Public Health Date: 2022-08-10 Impact factor: 4.614
Authors: Cinzia Perrino; Péter Ferdinandy; Hans E Bøtker; Bianca J J M Brundel; Peter Collins; Sean M Davidson; Hester M den Ruijter; Felix B Engel; Eva Gerdts; Henrique Girao; Mariann Gyöngyösi; Derek J Hausenloy; Sandrine Lecour; Rosalinda Madonna; Michael Marber; Elizabeth Murphy; Maurizio Pesce; Vera Regitz-Zagrosek; Joost P G Sluijter; Sabine Steffens; Can Gollmann-Tepeköylü; Linda W Van Laake; Sophie Van Linthout; Rainer Schulz; Kirsti Ytrehus Journal: Cardiovasc Res Date: 2021-01-21 Impact factor: 10.787