Comparison of demographic, psychosocial, and clinical characteristics among younger and older persons with acute coronary syndrome

Yammine, Luba; Frazier, Lorraine

doi:10.1111/j.1745-7599.2012.00779.x

Cited by 4 publications

(6 citation statements)

References 13 publications

(18 reference statements)

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“…Although overall survival is expected to be lower with age, studies have shown that younger patients may be more susceptible to depression. 29,30 We had missing data that we replaced with multiple imputation. Data collected in-hospital came from a register collected for routine purposes; thus, we can assume that missingness occurs completely at random.…”

Section: Discussionmentioning

confidence: 99%

Persistent emotional distress after a first-time myocardial infarction and its association to late cardiovascular and non-cardiovascular mortality

Lissåker

Norlund

Wallert

et al. 2019

Eur J Prev Cardiolog

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Background Patients with symptoms of depression and/or anxiety – emotional distress – after a myocardial infarction (MI) have been shown to have worse prognosis and increased healthcare costs. However, whether specific subgroups of patients with emotional distress are more vulnerable is less well established. The purpose of this study was to identify the association between different patterns of emotional distress over time with late cardiovascular and non-cardiovascular mortality among first-MI patients aged <75 years in Sweden. Methods We utilized data on 57,602 consecutive patients with a first-time MI from the national SWEDEHEART registers. Emotional distress was assessed using the anxiety/depression dimension of the European Quality of Life Five Dimensions questionnaire two and 12 months after the MI, combined into persistent (emotional distress at both time-points), remittent (emotional distress at the first follow-up only), new (emotional distress at the second-follow up only) or no distress. Data on cardiovascular and non-cardiovascular mortality were obtained until the study end-time. We used multiple imputation to create complete datasets and adjusted Cox proportional hazards models to estimate hazard ratios. Results Patients with persistent emotional distress were more likely to die from cardiovascular (hazard ratio: 1.46, 95% confidence interval: 1.16, 1.84) and non-cardiovascular causes (hazard ratio: 1.54, 95% confidence interval: 1.30, 1.82) than those with no distress. Those with remittent emotional distress were not statistically significantly more likely to die from any cause than those without emotional distress. Discussion Among patients who survive 12 months, persistent, but not remittent, emotional distress was associated with increased cardiovascular and non-cardiovascular mortality. This indicates a need to identify subgroups of individuals with emotional distress who may benefit from further assessment and specific treatment.

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Section: Discussionmentioning

confidence: 99%

Persistent emotional distress after a first-time myocardial infarction and its association to late cardiovascular and non-cardiovascular mortality

Lissåker

Norlund

Wallert

et al. 2019

Eur J Prev Cardiolog

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“…In our recent investigation (n=1140) [27], younger ACS patients (males ≤50 years of age and females ≤55 years of age) were more likely to feel depressed during the year preceding their admission for ACS (p<0.001) compared to their older counterparts. In that same study, younger patients were less likely to be dyslipidemic, hypertensive (p<0.001 for each), or diabetic (p=0.025) than older patients.…”

Section: Discussionmentioning

confidence: 99%

Two-year prognosis after acute coronary syndrome in younger patients: Association with feeling depressed in the prior year, and BDI-II score and Endothelin-1

Yammine

Frazier

Padhye

et al. 2017

Journal of Psychosomatic Research

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Objective To examine the effects of depressive symptoms and Endothelin (ET) -1 on 2-year prognosis in younger patients with acute coronary syndrome (ACS). Depression is associated with poor post-ACS prognosis; however, few investigations have focused on younger patients. Importantly, the studies that did emphasize younger patients suggested that the influence of depression on prognosis could be more robust in younger subgroups. The particular links between depression and poor prognosis in younger patients have yet to be definitively determined. ET-1 is a potent endogenous vasoconstrictor that has been previously linked to adverse post-ACS outcomes. Methods The sample (n=153) included male (age ≤50 years) and female (age ≤55 years) ACS patients. Blood samples for ET-1 assessment were collected within 2–3h of ACS hospital admission. Depressive symptoms were assessed with the Beck Depression Inventory (BDI) II within 2–5 days of admission. The primary outcome was defined as a composite of major adverse cardiovascular events (MACE), including recurrent myocardial infarction, emergent coronary revascularization, and all-cause mortality within 2 years after index admission. Results During the follow-up period, 23 patients experienced MACE. Neither the BDI-II score nor ET-1 predicted MACE in unadjusted analyses or in analyses adjusted for demographic characteristics, comorbidities and troponin levels. In the supplementary analyses, feeling depressed in the year preceding ACS predicted MACE. Conclusions In this cohort of younger ACS patients, feeling depressed in the year preceding ACS admission predicted MACE in the 2 years after baseline ACS event, while neither the BDI-II score, nor circulating ET-1 level predicted this outcome.

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“…This is probably due to the younger age of the study participants. Indeed, in our previous investigation (n=1140) [17], compared to their older counterparts, younger ACS patients (males ≤50 years of age and females ≤55 years of age) were significantly more likely to have a higher BDI-II depression score, and to feel depressed during the year preceding their admission for ACS. Importantly, in one study [19], after adjustment for disease severity and comorbidities, somatic symptoms of depression and hopelessness were associated with poor post-MI prognosis in younger, but not in older patients.…”

Section: Discussionmentioning

confidence: 99%

“…While ACS occurs more frequently at an older age, younger patients (males ≤50 years of age and females ≤55 years of age) constituted 20% of the total sample in a recent large study (n=1140) of consecutively admitted ACS patients (age range 26–96 years), [17]. This is an important finding, given the results of the few studies of ACS patients that specifically examined younger patients.…”

Section: Introductionmentioning

confidence: 93%

“…This is an important finding, given the results of the few studies of ACS patients that specifically examined younger patients. In particular, these younger patients apparently differ from their older counterparts with respect to psychosocial characteristics [17, 18]. In one study, younger ACS patients were significantly more likely to report greater depressive symptom severity on the Beck Depression Inventory (BDI) II questionnaire and to report feeling depressed in the year preceding the index event (p<0.001 for each), compared to their older counterparts [17].…”

Section: Introductionmentioning

confidence: 99%

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Severe depressive symptoms are associated with elevated endothelin-1 in younger patients with acute coronary syndrome

Yammine

Frazier

Padhye

et al. 2014

Journal of Psychosomatic Research

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Objective To explore the relationship of depressive symptom severity to circulating Endothelin (ET) – 1 in younger patients with acute coronary syndrome (ACS). Younger patients report greater depressive symptom severity, which predicts poorer post-ACS prognosis. The pathways linking depression to post-ACS prognosis require further elucidation. ET-1 is a potent endogenous vasoconstrictor which has been previously linked to adverse post-ACS outcomes. Methods The sample (n=153) included males ≤50 years of age and females ≤55 years of age who participated in a larger study. Blood samples for ET-1 assessment were collected within 2–3 hours of ACS admission. Depressive symptoms were assessed with the Beck Depression Inventory (BDI) II within 2–5 days of admission. ET-1 was treated as a transformed continuous variable (ET-1T). BDI-II scores were classified into four categories using conventional thresholds demarcating mild, moderate, and severe levels of depressive symptoms. The relationship of classified BDI-II score to ET-1T was examined in simple and multivariable linear regression models. Results Classified BDI-II score was related to ET-1T in both unadjusted (χ2 = 9.469, p = 0.024) and multivariable (χ2 = 8.430, p = 0.038) models, with ET-1T being significantly higher in patients with severe depressive symptoms than in those with mild and moderate depressive symptoms. Conclusions In this sample of younger post-ACS patients, severe depressive symptoms were associated with elevated ET-1. We acknowledge that the observed association could be eliminated by the inclusion of some unmeasured variable(s). Longitudinal research should examine whether ET-1 mediates the relationship of depressive symptoms to long-term post-ACS outcomes.

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Comparison of demographic, psychosocial, and clinical characteristics among younger and older persons with acute coronary syndrome

Cited by 4 publications

References 13 publications

Persistent emotional distress after a first-time myocardial infarction and its association to late cardiovascular and non-cardiovascular mortality

Persistent emotional distress after a first-time myocardial infarction and its association to late cardiovascular and non-cardiovascular mortality

Two-year prognosis after acute coronary syndrome in younger patients: Association with feeling depressed in the prior year, and BDI-II score and Endothelin-1

Severe depressive symptoms are associated with elevated endothelin-1 in younger patients with acute coronary syndrome

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