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Positive correlation found between depression, adverse CV events
Elderon L. Circ Cardiovasc Qual Outcomes. 2011;4:533-540.
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American Heart Association-recommended depression screening protocol identifies patients at risk for adverse CV outcomes among participants with stable coronary heart disease, according to researchers.
For this prospective cohort study, designed to examine the mechanisms of association between depression and CV outcomes in participants with stable CHD, researchers administered a two-step AHA-recommended screening algorithm, calculating sensitivity and specificity against a gold standard interview for major depressive disorder. Participants were included in the study if they had CHD and either a history of MI, angiographic evidence of stenosis in one or more coronary vessels of 50% or more, evidence of exercise induced ischemia or a history of coronary revascularization. Researchers kept track of self-report screening instruments for depression and telephone follow-up interviews about hospitalization for heart trouble from participants.
Overall, researchers found 187 participants had screened positive and 837 screened negative with depression, the screening method providing high specificity (95% CI, 0.89-0.93) but low sensitivity (95% CI, 0.46-0.59) for diagnosis. There was a 55% greater risk of events for participants who screened negative on the AHA depression protocol vs. those who screened positive (HR=1.55; 95% CI, 1.21-1.97).
Participants who screened positive for depression were younger, less likely to be male, and more likely to have a history of hypertension, MI, congestive HF, or diabetes, had a higher BMI and higher mean HDL, were more likely to smoke, to report medication nonadherence, and to be physically inactive vs. participants with negative depression screens, according to researchers.
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