Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device

KUZNETSOV, Vadim A.; FISHER, Yakov A.; SOLDATOVA, Anna M.; PUSHKAREV, Georgiy S.; ENINA, Tatiana N.

doi:10.5543/tkda.2018.04134

Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device

Georgiy S. Pushkarev, (Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia)

Vadim A. Kuznetsov, (Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia)

Yakov A. FISHER, (Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia)

Anna M. Soldatova, (Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia)

Tatiana N. ENINA (Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia)

Türk Kardiyoloji Derneği Arşivi

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Yıl: 2018 Cilt: 46 Sayı: 6 Sayfa Aralığı: 479 - 487 Metin Dili: İngilizce DOI: 10.5543/tkda.2018.04134 İndeks Tarihi: 22-07-2020

Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device

Öz:

Objective: The purpose of this study was to assess the associationbetween depression and all-cause mortality in patientswith congestive heart failure (CHF) and an implanted cardiacdevice.Methods: The study enrolled 260 patients (mean age56.8±10.0 years; 83.1% male) with CHF and an implantedcardiac device (156 patients with a resynchronization therapycardiac device, 104 patients with an implantable cardioverterdefibrillator). The mean duration of follow-up was 48.6±32.2months. The Beck Depression Inventory was used to measuredepressive symptoms. Depression was consideredabsent for a score between 0 and 9, mild to moderate for ascore between 10 and 18, and severe if the score was 19 orgreater. The Cox proportional hazards regression model wasused to estimate hazard ratios (HR) with a 95% confidenceinterval (CI) for the impact of depression on all-cause mortality.The HR was calculated after adjustment for the followingconfounders: age, gender, smoking status, hypertension,diabetes mellitus, body mass index, hypercholesterolemia,left ventricular ejection fraction, number of hemodynamicallysignificant lesions of the coronary arteries, and the type ofimplanted cardiac device.Results: During the follow-up period, 37 patients died(14.2%). The adjusted HR of depression for all-cause mortalitywas 1.05, with a 95% CI of 1.01–1.09. Patients withoutdepression were accepted as a reference group with HR=1.0for analysis of the categorical indicator. The HR was 1.32, witha 95% CI of 0.57–3.03, in patients with mild depressive symptoms,and the HR was 3.18 with a 95% CI of 1.31–7.73 inpatients with severe depressive symptoms.Conclusion: Increased depressive symptoms were independentlyassociated with all-cause mortality in patients with CHFand an implanted cardiac device.

Anahtar Kelime:

Kardiyak cihaz implante edilmiş konjestif kalp yetersizliği olan hastalarda depresyon ve tüm nedenlere bağlı mortalite

Öz:

Amaç: Çalışmanın amacı kardiyak cihaz implante edilmiş konjestif kalp yetersizliği (KKY) hastalarında depresyon ile tüm nedenlere bağlı mortalite arasındaki ilişkiyi değerlendirmekti. Yöntemler: Çalışmaya kardiyak cihaz implante edilmiş 360 hasta (yaş ortalaması, 56.8±10.0 yıl, %83.1’i erkek hasta) (156 hastaya resenkronizasyon tedavisi için kardiyak cihaz, 104 hastaya ise kardiyoversiyon için defibrilatör takılmış) alındı. Ortalama izlem süresi 48.6±32.2 aydı. Depresif semptomları değerlendirmek için Beck Depresyon Envanteri (BDI) kullanıldı. BDI skoru 0–9 olanlarda depresyonun olmadığı, 10–18 arası hafif-orta derecede depresyon ve 19’dan yüksekse hastaların ağır depresyonda olduğu kabul edildi. Depresyonun tüm nedenlere bağlı mortaliteye etkisini değerlendirmede %95 güven aralığında risk oranlarını (HR) tahmin etme amacıyla Cox orantısal riskler modeli kullanıldı. Karışıklığa neden olan faktörler (yaş, cinsiyet, sigara içme durumu, hipertansiyon, diabetes mellitus, beden kütle indeksi, hiperkolesterolemi, sol ventrikül ejeksiyon fraksiyonu, koroner arterlerin hemodinamik açıdan önemli olan lezyonlarının sayısı ve implante edilmiş kardiyak cihazların tipi) için düzenlemeler yapıldıktan sonra HR hesaplandı. Bulgular: İzlem dönemi sırasında 37 (%14.2) hasta hayatını kaybetti. Depresyon skoruna tüm nedenlere bağlı mortalitenin etkisi için düzeltilmiş HR 1.05 (%95 GA 1.01–1.09) idi. Depresyonu olmayan hastalar (HR=1.0) kategorik göstergelerin analizi için referans grubu olarak kabul edildi. HR, hafif depresif semptomları olanlarda 1.32 (%95 GA 0.57–3.03), ağır depresif semptomları olanlarda 3.18 (%95 GA 1.31– 7.73) idi. Sonuç: Artmış depresif semptomlar kardiyak cihaz implante edilmiş KKY olan hastalarda tüm nedenlere bağlı mortaliteyle bağımsız olarak korelasyon göstermektedir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	PUSHKAREV G, KUZNETSOV V, FISHER Y, SOLDATOVA A, ENINA T (2018). Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. , 479 - 487. 10.5543/tkda.2018.04134
Chicago	PUSHKAREV Georgiy S.,KUZNETSOV Vadim A.,FISHER Yakov A.,SOLDATOVA Anna M.,ENINA Tatiana N. Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. (2018): 479 - 487. 10.5543/tkda.2018.04134
MLA	PUSHKAREV Georgiy S.,KUZNETSOV Vadim A.,FISHER Yakov A.,SOLDATOVA Anna M.,ENINA Tatiana N. Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. , 2018, ss.479 - 487. 10.5543/tkda.2018.04134
AMA	PUSHKAREV G,KUZNETSOV V,FISHER Y,SOLDATOVA A,ENINA T Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. . 2018; 479 - 487. 10.5543/tkda.2018.04134
Vancouver	PUSHKAREV G,KUZNETSOV V,FISHER Y,SOLDATOVA A,ENINA T Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. . 2018; 479 - 487. 10.5543/tkda.2018.04134
IEEE	PUSHKAREV G,KUZNETSOV V,FISHER Y,SOLDATOVA A,ENINA T "Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device." , ss.479 - 487, 2018. 10.5543/tkda.2018.04134
ISNAD	PUSHKAREV, Georgiy S. vd. "Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device". (2018), 479-487. https://doi.org/10.5543/tkda.2018.04134

APA	PUSHKAREV G, KUZNETSOV V, FISHER Y, SOLDATOVA A, ENINA T (2018). Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. Türk Kardiyoloji Derneği Arşivi, 46(6), 479 - 487. 10.5543/tkda.2018.04134
Chicago	PUSHKAREV Georgiy S.,KUZNETSOV Vadim A.,FISHER Yakov A.,SOLDATOVA Anna M.,ENINA Tatiana N. Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. Türk Kardiyoloji Derneği Arşivi 46, no.6 (2018): 479 - 487. 10.5543/tkda.2018.04134
MLA	PUSHKAREV Georgiy S.,KUZNETSOV Vadim A.,FISHER Yakov A.,SOLDATOVA Anna M.,ENINA Tatiana N. Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. Türk Kardiyoloji Derneği Arşivi, vol.46, no.6, 2018, ss.479 - 487. 10.5543/tkda.2018.04134
AMA	PUSHKAREV G,KUZNETSOV V,FISHER Y,SOLDATOVA A,ENINA T Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. Türk Kardiyoloji Derneği Arşivi. 2018; 46(6): 479 - 487. 10.5543/tkda.2018.04134
Vancouver	PUSHKAREV G,KUZNETSOV V,FISHER Y,SOLDATOVA A,ENINA T Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device. Türk Kardiyoloji Derneği Arşivi. 2018; 46(6): 479 - 487. 10.5543/tkda.2018.04134
IEEE	PUSHKAREV G,KUZNETSOV V,FISHER Y,SOLDATOVA A,ENINA T "Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device." Türk Kardiyoloji Derneği Arşivi, 46, ss.479 - 487, 2018. 10.5543/tkda.2018.04134
ISNAD	PUSHKAREV, Georgiy S. vd. "Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device". Türk Kardiyoloji Derneği Arşivi 46/6 (2018), 479-487. https://doi.org/10.5543/tkda.2018.04134