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Short-term depressive symptoms and 30-day prognosis of hospitalized patients with Acute Coronary Syndromes; the Greek Study of Acute Coronary Syndromes (GREECS)

Published online by Cambridge University Press:  18 May 2011

Christos Pitsavos ,
Demosthenes B. Panagiotakos ,
Sophia Arapi ,
George Giannopoulos ,
Constandina Masoura ,
Eleftherios Tsiamis  and
Christodoulos Stefanadis
Christos Pitsavos
Affiliation:
First Cardiology Clinic, School of Medicine, University of Athens, Athens (Greece)
Demosthenes B. Panagiotakos*
Affiliation:
Department of Dietetic-Nutrition, Harokopio University, Athens (Greece)
Sophia Arapi
Affiliation:
First Cardiology Clinic, School of Medicine, University of Athens, Athens (Greece)
George Giannopoulos
Affiliation:
First Cardiology Clinic, School of Medicine, University of Athens, Athens (Greece)
Constandina Masoura
Affiliation:
First Cardiology Clinic, School of Medicine, University of Athens, Athens (Greece)
Eleftherios Tsiamis
Affiliation:
First Cardiology Clinic, School of Medicine, University of Athens, Athens (Greece)
Christodoulos Stefanadis
Affiliation:
Department of Dietetic-Nutrition, Harokopio University, Athens (Greece)
*
Address for correspondence: Dr. D.B. Panagiotakos, 46 Paleon Polemiston St. 166 74 Glyfada, Attica (Greece). Fax: +30-2109600719 E-mail: [email protected]
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Summary

Aims – We evaluated whether short-term depressive symptoms are associated with the 30-day prognosis of hospitalized patients presented with acute coronary syndromes (ACS). Methods – A sample of 6 hospitals located in Greek urban and rural regions was selected. From October 2003 to September 2004, we recorded the non-fatal admissions of ACS. Assessment of depressive symptoms, during past month, was based on the CES-D scale (Radloff S., 1977). Results – 2172 patients were included in the study (1649, 76% were males). The mean CES-D score was 13.5±12 in male patients and 13.6±12 in females (p=0.89). Compared to patients with angina those who had non-Q-wave MI or Q-wave MI had higher CES-D score (12.3±11.6 vs. 15.3±12.8 vs. 13.2±11.9, p=0.001). The number of events during the first 30-day following discharge was 9.2% in males and 9.7% in females. Multivariable logistic regression analysis revealed that 1-unit increase in CES-D was associated with 10% higher odds (95% CI 1.09–1.12) of re-current events (death or re-hospitalization), after adjusting for various socio-demographic, lifestyle and clinical factors. Conclusion – We revealed that short-term depressive symptoms are related to more severe disease and a worsen 30-day prognosis of patients hospitalized for ACS.

Declaration of Interest: None.

Keywords

coronary syndromesdepressionGreeceepidemiology
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 16 , Issue 4 , December 2007 , pp. 309 - 315
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

Ariyo, A.A., Haan, M., Tangen, C.M., Rutledge, J.C., Cushman, M., Dobs, A. & Furberg, C.D. (2000). Depressive symptoms and risks of coronary heart disease and mortality in elderly Americans. Cardiovascular Health Study Collaborative Research Group. Circulation 102, 1773–1779.CrossRefGoogle ScholarPubMed
Barth, J., Schumacher, M. & Herrmann-Lingen, C. (2004). Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosomatic Medicine 66, 802–813.CrossRefGoogle ScholarPubMed
Braunwald, E. (1997). Heart Disease, 5th ed.WB Saunders Company: London.Google Scholar
Carney, R.M., Saunders, R.D., Freedland, K.E., Stein, P., Rich, M.W. & Jaffe, A.S. (1995). Association of depression with reduced heart rate variability in coronary artery disease. American Journal of Cardiology 76, 562–564.CrossRefGoogle ScholarPubMed
Carney, R.M., Howells, W.B., Blumenthal, J.A., Freedland, K.E., Stein, P.K., Berkman, L.F., Watkins, L.L., Czajkowski, S.M., Steinmeyer, B., Hayano, J., Domitrovich, P.P., Burg, M.M. & Jaffe, A.S. (2007). Heart rate turbulence, depression, and survival after acute myocardial infarction. Psychosomatic Medicine 69, 4–9.CrossRefGoogle ScholarPubMed
Davidson, K.W., Rieckmann, N.Lesperance, F. (2004). Psychological theories of depression: potential application for the prevention of acute coronary syndrome recurrence. Psychosomatic Medicine 66, 165–173.CrossRefGoogle ScholarPubMed
Depression Guideline Panel (1993). Depression in Primary Care. Clinical Practice Guideline, no 5. AHCPR publication no. 93–0551. US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research: Rockville, MD.Google Scholar
Dickens, C., McGowan, L., Percival, C., Tomenson, B., Cotter, L., Heagerty, A. & Creed, F. (2007). Depression is a risk factor for mortality after myocardial infarction: fact or artifact? Journal of American College of Cardiology 49, 1834–1840.CrossRefGoogle ScholarPubMed
Gehi, A., Haas, D., Pipkin, S. & Whooley, M.A. (2005). Depression and medication adherence in outpatients with coronary heart disease: findings from the Heart and Soul Study. Archives of Internal Medicine 165, 2508–2513.CrossRefGoogle ScholarPubMed
Lefer, A.M. (1987). Interaction between myocardial depressant factor and vasoactive mediators with ischemia and shock. American Journal of Physiology 252, R193–205.Google ScholarPubMed
Myocardial infarction redefined a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction (2000). European Heart Journal 21, 1502–1513.CrossRefGoogle Scholar
Panagiotakos, D.B., Pitsavos, C., Chrysohoou, C., Moraiti, A.D., Stefanadis, C.I. & Toutouzas, P.K. (2001). The effect of short-term depressive episodes on the risk stratification of acute coronary syndromes: a case-control study in Greece (Cardio 2000). Ada Cardiologica 56, 357–565CrossRefGoogle ScholarPubMed
Panagiotakos, D.B., Pitsavos, C., Chrysohoou, C., Tsetsekou, E., Papageorgiou, C., Christodoulou, G. & Stefanadis, C. (2004). ATTICA study. Inflammation, coagulation, and depressive symptomatology in cardiovascular disease-free people; the ATTICA study. European Heart Journal 25, 492–499.CrossRefGoogle ScholarPubMed
Panagiotakos, D.B., Pitsavos, C. & Stefanadis, C. (2006). Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutrition, Metabolism, and Cardiovascular Diseases 16, 559–568.CrossRefGoogle ScholarPubMed
Parissis, J.T., Fountoulaki, K., Filippatos, G., Adamopoulos, S.Paraskevaidis, I. & Kremastinos, D. (2007). Depression in coronary artery disease: novel pathophysiologic mechanisms and therapeutic implications. International Journal of Cardiology 116, 153–160.CrossRefGoogle ScholarPubMed
Pate, R.R., Pratt, M., Blair, S.N., Haskell, W.L., Macera, C.A., Bouchard Buchner, D., Ettinger, W., Heath, G.W. & King, A.C. (1995). Physical activity and public health. A recommendation from the Centers Disease Control and Prevention and the American College of Sports Medicine. Journal of American Medical Association 273, 402–407CrossRefGoogle Scholar
Pitsavos, C., Panagiotakos, D.B., Antonoulas, A., Zombolos, S., Kogias, Y., Mantas, Y., Stravopodis, P., Kourlaba, G. & Stefanadis, C. (2005). Greek study of acute Coronary Syndromes study investigators. Epidemiology of acute coronary syndromes in a Mediterranean country; aims, design and baseline characteristics of the Greek of acute coronary syndromes (GREECS). BMC Public Health 5, 23CrossRefGoogle Scholar
Radloff, L.S. (1977). The CES-D scale: A self-report depression for research in the general population. Applied Psychological Measurement 1, 385–401.CrossRefGoogle Scholar
Rozanski, A., Blumenthal, J. & Kaplan, J. (1999). Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 99, 2192–2217.CrossRefGoogle ScholarPubMed
Rugulies, R. (2002). Depression as a predictor for coronary heart disease: a review and meta-analysis. American Journal of Preventive Medicine 23, 51–61.CrossRefGoogle ScholarPubMed
Schroevers, M.J., Sanderman, R., van Sonderen, E. & Ranchor, A.V. (2000). The evaluation of the Center for Epidemiologic Studies Depression (CES-D) scale: Depressed and Positive Affect in cancer patients healthy reference subjects. Quality of Life Research 9, 1015–1029.CrossRefGoogle Scholar
Skala, J.A., Freedland, K.E. & Carney, R.M. (2006). Coronary heart disease and depression: a review of recent mechanistic research. Canadian Journal of Psychiatry 51, 738–745.CrossRefGoogle ScholarPubMed
Steptoe, A. & Whitehead, D.L. (2005). Depression, stress, and coronary heart disease: the need for more complex models. Heart 91,419–420CrossRefGoogle ScholarPubMed
Sundquist, J., Li, X., Johansson, S.E. & Sundquist, K. (2005). Depression as a predictor of hospitalization due to coronary heart disease. American Journal of Preventive Medicine 29, 428–433.CrossRefGoogle ScholarPubMed
Tansella, M. (2006). Recent advances in depression. Where are going? Epidemiologia e Psichiatria Sociale 15, 1–3.CrossRefGoogle ScholarPubMed
van Melle, J.P., de Jonge, P., Ormel, J., Crijns, H.J., van Veldhuisen, D.J., Honig, A., Schene, A.H., van den Berg, M.P. & MIND-IT investigators (2005). Relationship between left ventricular dysfunction depression following myocardial infarction: data from the MINDIT. European Heart Journal 26, 2650–2656.CrossRefGoogle ScholarPubMed
Vieweg, W.V., Julius, D.A., Fernandez, A., Wulsin, L.R., Mohanty, P.K.Beatty-Brooks, M., Hasnain, M. & Pandurangi, A.K. (2006). Treatment of depression in patients with coronary heart disease. American Journal of Medicine 119, 567–573.CrossRefGoogle ScholarPubMed
Whooley, M.A. (2006). Depression and cardiovascular disease: healing the broken-hearted. Journal of the American Medical Association 295, 2874–2881.CrossRefGoogle ScholarPubMed
Wolkowitz, O.M. & Reus, V.I. (1999). Treatment of depression antiglucocorticoid drugs. Psychosomatic Medicine 61, 698–711.CrossRefGoogle ScholarPubMed
Wulsin, L.R. & Singal, B.M. (2003). Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosomatic Medicine 65, 201–210.CrossRefGoogle ScholarPubMed