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Comorbid Depression and Heart Failure: A Community Cohort Study
OBJECTIVE: To examine the association between depression and clinical outcomes in heart failure (HF) in a community cohort. PATIENTS AND METHODS: HF patients in Minnesota, United States completed depression screening using the 9-item Patient Health Questionnaire (PHQ-9) between 1(st) Oct 2007 and 1(...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928788/ https://www.ncbi.nlm.nih.gov/pubmed/27362359 http://dx.doi.org/10.1371/journal.pone.0158570 |
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author | Jani, Bhautesh Dinesh Mair, Frances S. Roger, Véronique L. Weston, Susan A. Jiang, Ruoxiang Chamberlain, Alanna M. |
author_facet | Jani, Bhautesh Dinesh Mair, Frances S. Roger, Véronique L. Weston, Susan A. Jiang, Ruoxiang Chamberlain, Alanna M. |
author_sort | Jani, Bhautesh Dinesh |
collection | PubMed |
description | OBJECTIVE: To examine the association between depression and clinical outcomes in heart failure (HF) in a community cohort. PATIENTS AND METHODS: HF patients in Minnesota, United States completed depression screening using the 9-item Patient Health Questionnaire (PHQ-9) between 1(st) Oct 2007 and 1(st) Dec 2011; patients with PHQ-9≥5 were labelled “depressed”. We calculated the risk of death and first hospitalization within 2 years using Cox regression. Results were adjusted for 10 commonly used prognostic factors (age, sex, systolic blood pressure, estimated glomerular filtration rate, serum sodium, ejection fraction, blood urea nitrogen, brain natriuretic peptide, presence of diabetes and ischaemic aetiology). Area under the curve (AUC), integrated discrimination improvement (IDI) and net reclassification improvement (NRI) compared depression as a predictor against the aforementioned factors. RESULTS: 425 patients (mean age 74, 57.6% males) were included in the study; 179 (42.1%) had PHQ-9≥5. The adjusted hazard ratio of death was 2.02 (95% CI 1.34–3.04) and of hospitalization was 1.42 (95% CI 1.13–1.80) for those with compared to those without depression. Adding depression to the models did not appreciably change the AUC but led to statistically significant improvements in both the IDI (p = 0.001 and p = 0.005 for death and hospitalization, respectively) and NRI (for death and hospitalization, 35% (p = 0.002) and 27% (p = 0.007) were reclassified correctly, respectively). CONCLUSION: Depression is frequent among community patients with HF and associated with increased risk of hospitalizations and death. Risk prediction for death and hospitalizations in HF patients can be improved by considering depression. |
format | Online Article Text |
id | pubmed-4928788 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-49287882016-07-18 Comorbid Depression and Heart Failure: A Community Cohort Study Jani, Bhautesh Dinesh Mair, Frances S. Roger, Véronique L. Weston, Susan A. Jiang, Ruoxiang Chamberlain, Alanna M. PLoS One Research Article OBJECTIVE: To examine the association between depression and clinical outcomes in heart failure (HF) in a community cohort. PATIENTS AND METHODS: HF patients in Minnesota, United States completed depression screening using the 9-item Patient Health Questionnaire (PHQ-9) between 1(st) Oct 2007 and 1(st) Dec 2011; patients with PHQ-9≥5 were labelled “depressed”. We calculated the risk of death and first hospitalization within 2 years using Cox regression. Results were adjusted for 10 commonly used prognostic factors (age, sex, systolic blood pressure, estimated glomerular filtration rate, serum sodium, ejection fraction, blood urea nitrogen, brain natriuretic peptide, presence of diabetes and ischaemic aetiology). Area under the curve (AUC), integrated discrimination improvement (IDI) and net reclassification improvement (NRI) compared depression as a predictor against the aforementioned factors. RESULTS: 425 patients (mean age 74, 57.6% males) were included in the study; 179 (42.1%) had PHQ-9≥5. The adjusted hazard ratio of death was 2.02 (95% CI 1.34–3.04) and of hospitalization was 1.42 (95% CI 1.13–1.80) for those with compared to those without depression. Adding depression to the models did not appreciably change the AUC but led to statistically significant improvements in both the IDI (p = 0.001 and p = 0.005 for death and hospitalization, respectively) and NRI (for death and hospitalization, 35% (p = 0.002) and 27% (p = 0.007) were reclassified correctly, respectively). CONCLUSION: Depression is frequent among community patients with HF and associated with increased risk of hospitalizations and death. Risk prediction for death and hospitalizations in HF patients can be improved by considering depression. Public Library of Science 2016-06-30 /pmc/articles/PMC4928788/ /pubmed/27362359 http://dx.doi.org/10.1371/journal.pone.0158570 Text en © 2016 Jani et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Jani, Bhautesh Dinesh Mair, Frances S. Roger, Véronique L. Weston, Susan A. Jiang, Ruoxiang Chamberlain, Alanna M. Comorbid Depression and Heart Failure: A Community Cohort Study |
title | Comorbid Depression and Heart Failure: A Community Cohort Study |
title_full | Comorbid Depression and Heart Failure: A Community Cohort Study |
title_fullStr | Comorbid Depression and Heart Failure: A Community Cohort Study |
title_full_unstemmed | Comorbid Depression and Heart Failure: A Community Cohort Study |
title_short | Comorbid Depression and Heart Failure: A Community Cohort Study |
title_sort | comorbid depression and heart failure: a community cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928788/ https://www.ncbi.nlm.nih.gov/pubmed/27362359 http://dx.doi.org/10.1371/journal.pone.0158570 |
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