Depression and 1-Year Prognosis in Unstable Angina

Lespérance, François; Frasure-Smith, Nancy; Juneau, Martin; Théroux, Pierre

doi:10.1001/archinte.160.9.1354

Cited by 343 publications

(202 citation statements)

References 44 publications

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“…Second, the sample consisted of patients with stable or unstable angina as indication for PCI, and the results may not generalize to patients with acute MI. Nevertheless, psychosocial factors have been shown to predict mortality in these patients, emphasizing the relevance of also studying the impact of co-occurring risk factors in MI patients (Lespérance et al 2000). Our results support this notion.…”

Section: Discussionsupporting

confidence: 83%

Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention

et al. 2009

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We examined the impact of co-occurring diabetes and hopelessness on 3-year prognosis in percutaneous coronary intervention patients. Consecutive patients (n = 534) treated with the paclitaxel-eluting stent completed a set of questionnaires at baseline and were followed up for 3-year adverse clinical events. The incidence of 3-year death/non-fatal myocardial infarction was 3.5% in patients with no risk factors (neither hopelessness nor diabetes), 8.2% in patients with diabetes, 11.2% in patients with high hopelessness, and 15.9% in patients with both factors (p = 0.001). Patients with hopelessness (HR: 3.28; 95% CI: 1.49-7.23) and co-occurring diabetes and hopelessness (HR: 4.89; 95% CI: 1.86-12.85) were at increased risk of 3-year adverse clinical events compared to patients with no risk factors, whereas patients with diabetes were at a clinically relevant but not statistically significant risk (HR: 2.40; 95% CI: 0.82-7.01). These results remained, adjusting for baseline characteristics and depressive symptoms. These findings testify to the importance of identifying patients with co-occurring risk factors, as they likely require special management in clinical practice in addition to standard medical treatment.

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Section: Discussionsupporting

confidence: 83%

Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention

et al. 2009

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“…6 Another study from the same group suggests that the risk resides in general psychological distress (eg, as measured by questionnaire) rather than a diagnosable psychiatric syndrome such as major depression. 7 There have been fewer studies examining depression as a risk in stroke. A recently published cohort study from the United States found an increased mortality from stroke in people who had self-reported depressive symptoms at recruitment 29 years previously; this association remained significant after adjusting for known clinical and behavioral risk factors.…”

mentioning

confidence: 99%

“…In the present study, we report a cohort enrolled within a randomized controlled trial, in which we examined the effect of depression identified 1 month after stroke on mortality at 12 and 24 months after stroke. Because of the findings of Lesperance et al, 7 suggesting a role for depression symptoms below diagnostic criteria, we defined depression both by standardized clinical interview and the application of research diagnostic criteria and by scores on a self-reported questionnaire.…”

mentioning

confidence: 99%

Mortality at 12 and 24 Months After Stroke May Be Associated With Depressive Symptoms at 1 Month

House

Knapp

Bamford

et al. 2001

Stroke

356

224

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Background and Purpose-Previous studies have reported mood symptoms after stroke to be a risk factor for later mortality. The purpose of the study was to examine whether mood symptoms at 1 month after stroke may be a risk factor for mortality at 12 and 24 months. Methods-As a cohort within a randomized controlled trial, 448 hospital patients were seen at 1 month after stroke and were randomized into a trial of psychological therapy. Follow-up was at 12 and 24 months. Mood symptoms were assessed by the Present State Examination and the General Health Questionnaire (GHQ)-28. Measures of disability before and after stroke and of cognitive impairment after stroke were also taken at 1 month. Mortality was determined at 12 and 24 months after stroke. Results-In logistic regression analyses, mortality at 12 months was associated unifactorally with scoring on the GHQ-D subscale (odds ratio [OR] 2.4, 95% CI 1.3 to 4.5) and scoring in the highest quartile of the GHQ (OR 3.1, 95% CI 1.1 to 8.8). In multiple logistic regression analyses, only GHQ-D remained a significant predictor after controlling for other known predictors. At 24 months, scoring on GHQ-D (OR 2.4, 95% CI 1.4 to 4.1) and in the highest GHQ quartile (OR 2.2, 95% CI 1.0 to 4.8) was significantly associated with mortality in unifactoral analyses. Scoring on the GHQ-D remained a predictor of mortality after controlling for other variables. Psychiatric disorder, such as major depression (according to International Classification of Diseases, 10th Revision), was not statistically significantly associated with increased mortality at 12 or 24 months. Conclusions-Mood symptoms on a self-reported rating scale were associated with 12-and 24-month mortality after stroke, after adjustment for factors associated with stroke severity. The result is in keeping with other evidence that depressive symptoms are a risk factor for death from vascular disease.

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“…Indeed, depression is common in patients after MI and has been found to be a risk factor for adverse outcomes after ACS [30,31,32]. Our study demonstrated that mental HRQL had a marginal influence on work performance.…”

Section: Discussionmentioning

confidence: 63%

Perceived Work Performance of Patients who Experienced an Acute Coronary Syndrome Event

Ellis

Eagle²,

Kline–Rogers

et al. 2005

Cardiology

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The objectives of this study were to describe the perceived work performance of patients previously diagnosed with acute coronary syndrome (ACS) and to determine the relationship between patient-specific variables and perceived work performance. This cross-sectional study utilized a mailed survey to all patients discharged from a university affiliated hospital with the diagnosis of ACS during a 3-year period. Perceived work performance was measured using the Work Performance Scale (WPS). Independent variables included health status (SF-8, PCS-8, MCS-8 and EQ-5D visual analog scale), cardiac functional status (Duke activity status index), symptom count, comorbidity index, patient-perceived cardiac disease severity, medication count and compliance, job satisfaction, current employment duration, patient demographics and ACS type. Step-wise multivariate linear regression models determined the independent variables with significant association (p < 0.05) to WPS. Of 1,217 patients surveyed, 490 (40%) responded, including 158 currently working (study sample). The regression model with the highest explanatory ability (r² = 0.29) included number of symptoms, age, perceived cardiac severity and PCS-8, with more symptoms, higher perceived severity, higher age and lower PCS-8 scores associated with lower WPS. Currently employed ACS patients report a high level of work performance. Symptom burden, perceived disease severity, age and physical function appear to be associated with perceived work performance.

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Depression and 1-Year Prognosis in Unstable Angina

Cited by 343 publications

References 44 publications

Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention

Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention

Mortality at 12 and 24 Months After Stroke May Be Associated With Depressive Symptoms at 1 Month

Perceived Work Performance of Patients who Experienced an Acute Coronary Syndrome Event

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