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Elevated depression symptoms predict long-term cardiovascular mortality in patients with atrial fibrillation and heart failure.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Frasure-Smith, Nancy Lespérance, François Habra, Martine E. Talajic, Mario R. Khairy, Paul Dorian, P. Roy, Denis G. |
| Copyright Year | 2009 |
| Abstract | BACKGROUND Depression predicts prognosis in many cardiac conditions, including congestive heart failure (CHF). Despite heightened cardiac risk in patients with comorbid atrial fibrillation (AF) and CHF, depression has not been studied in this group. This substudy, from the AF-CHF Trial of rate- versus rhythm-control strategies, investigated whether depression predicts long-term cardiovascular mortality in patients with left ventricular ejection fraction or=14). Over a mean follow-up of 39 months, there were 246 cardiovascular deaths (111 presumed arrhythmic; 302 all-cause deaths). Cox proportional hazards models adjusted for other prognostic factors (including age, marital status, cause of CHF, creatinine level, left ventricular ejection fraction, paroxysmal AF, previous AF hospitalization, previous electrical conversion, and baseline medications) showed that elevated depression scores significantly predicted cardiovascular mortality (primary outcome), arrhythmic death, and all-cause mortality. The adjusted hazard ratios were 1.57 (95% confidence interval 1.20 to 2.07, P<0.001), 1.69 (95% confidence interval 1.13 to 2.53, P=0.01), and 1.38 (95% confidence interval 1.07 to 1.77, P=0.01), respectively. The risks associated with depression and marital status were additive, with the highest risk in depressed patients who were unmarried. CONCLUSIONS Elevated depression symptoms are related to cardiovascular mortality even after adjustment for other prognostic indicators in patients with comorbid AF and CHF who receive optimized treatment. Unmarried patients are also at increased risk. Mechanisms and treatment options deserve additional study. |
| Starting Page | 135606 |
| Ending Page | 135606 |
| Page Count | 1 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/120/2/134.full.pdf?download=true |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/120/2/134.full.pdf |
| PubMed reference number | 19564557v1 |
| Alternate Webpage(s) | https://doi.org/10.1161/CIRCULATIONAHA.109.851675 |
| DOI | 10.1161/circulationaha.109.851675 |
| Journal | Circulation |
| Volume Number | 120 |
| Issue Number | 2 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Antidepressive Agents Cardiovascular Diseases Cessation of life Confidence Intervals Conflict (Psychology) Congestive heart failure Coronary Artery Disease Creatinine Critical Illness Depressive disorder Ejection fraction (procedure) Forecast of outcome Heart Atrium Hospitalization Omega-3 Fatty Acids Paroxysmal atrial fibrillation Patients Serotonin Uptake Inhibitors Status Epilepticus Ventricular Fibrillation |
| Content Type | Text |
| Resource Type | Article |
