Article

Symptoms of depression and anxiety contribute to determining
prognosis of patients with coronary heart disease. We evaluated the association
of the one-year course of symptoms of anxiety and depressive symptoms with fatal
and non-fatal cardiovascular disease-events during 10-year follow-up and assessed
the utilization of anti-depressant and psycholeptic medication. METHODS:
Prospective cohort study in coronary heart disease patients aged 30-70 years with
stable coronary heart disease. Symptoms of anxiety and depression were evaluated
at baseline and follow-up using the Hospital Anxiety and Depression Scale.
Associations with fatal and non-fatal cardiovascular disease events were
determined by a Cox-proportional hazards model. RESULTS: Nine hundred and
ninety-six patients were included in this study. Of the 862 patients with a
normal depression symptom score at baseline 10.3% had an increased score at
one-year follow-up. Of those with an elevated symptom score at baseline, 62.7%
still had an elevated score after one year. During follow-up (median 8.9 years)
fatal and non-fatal cardiovascular disease events were observed in 152 patients.
One year course of depressive symptoms was associated with cardiovascular disease
events during follow-up (p-value for trend 0.029); for example, patients with an
increase of depressive symptoms had a hazard ratio of 1.93 (95% confidence
interval 1.08-3.34) compared with patients with a normal score at baseline as
well as at one-year follow-up. However, if physical activity was considered as a
covariate, the HRs attenuated and the association was no longer statistically
significant. The utilization of anti-depressant medication in the overall
population was low (overall 2%). CONCLUSIONS: The study supports a role of the
one year course of symptoms of depression for long-term prognosis of patients
with known coronary heart disease, which might be partly mediated by lack of
physical activity.
CI - (c) The European Society of Cardiology 2014.

Langue : ANGLAIS