Journal
CIRCULATION JOURNAL
Volume 75, Issue 10, Pages 2465-2473Publisher
JAPANESE CIRCULATION SOC
DOI: 10.1253/circj.CJ-11-0140
Keywords
Cardiovascular disease; Depression; Inpatient; Mortality; Outcome
Categories
Funding
- Japan Research Promotion Society for Cardiovascular Diseases
- Health Labour Sciences Research Grant
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Background: Several studies have suggested that depression poses a risk in cardiovascular patients. The aim of the present study was to evaluate the prevalence of depression and its effect on cardiovascular events and mortality in Japanese inpatients with cardiovascular disease. Methods and Results: A total of 505 patients hospitalized with cardiovascular disease (28% female; mean age, 61 +/- 14 years; 31% ischemic heart disease; 47% New York Heart Association [NYHA] class II-IV; 25% implantation of pacing devices) were enrolled in the present prospective observational study. The Zung Self-Rating Depression Scale (SDS) was used to screen for depression. The primary outcome was the time to death or cardiovascular event, and the secondary outcome was death. In total, 109 patients (22%) were diagnosed with depression (Zung SDS index score 60). NYHA class III/IV, defibrillator implantation, and being unmarried were independently associated with depression. During an average follow-up period of 38 +/- 15 months, 92 patients (18%) reached the primary outcome. There was a higher incidence of the primary outcome in patients with depression than in those who were not depressed (P < 0.01). Depressed patients had a significantly higher rate of mortality than non-depressed patients (P < 0.01). Depression was an independent predictor of the primary outcome (hazard ratio, 2.25; 95% confidence interval: 1.30-3.92, P < 0.01). Conclusions: Depression was not uncommon in Japanese inpatients with cardiovascular disease and was associated with cardiovascular outcomes. (Circ J 2011; 75: 2465-2473)
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