Cargando…

Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors

AIMS: This study aims to analyse the factors associated with prognosis in hospitalized patients with heart failure, particularly the role of depressive symptoms, and to develop a prediction model for depressive symptoms based on clinical characteristics in hospitalized patients with heart failure. M...

Descripción completa

Detalles Bibliográficos
Autores principales: Duan, Jiahao, Huang, Kai, Zhang, Xinying, Wang, Ruting, Chen, Zijun, Wu, Zifeng, Huang, Chaoli, Yang, Chun, Yang, Ling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9288805/
https://www.ncbi.nlm.nih.gov/pubmed/35620885
http://dx.doi.org/10.1002/ehf2.13993
_version_ 1784748529836621824
author Duan, Jiahao
Huang, Kai
Zhang, Xinying
Wang, Ruting
Chen, Zijun
Wu, Zifeng
Huang, Chaoli
Yang, Chun
Yang, Ling
author_facet Duan, Jiahao
Huang, Kai
Zhang, Xinying
Wang, Ruting
Chen, Zijun
Wu, Zifeng
Huang, Chaoli
Yang, Chun
Yang, Ling
author_sort Duan, Jiahao
collection PubMed
description AIMS: This study aims to analyse the factors associated with prognosis in hospitalized patients with heart failure, particularly the role of depressive symptoms, and to develop a prediction model for depressive symptoms based on clinical characteristics in hospitalized patients with heart failure. METHODS AND RESULTS: Baseline information was collected at admission, and patients were followed up after discharge. The endpoint events were being hospitalized for heart failure or all‐cause death. Depressive symptoms were evaluated and defined via the Patient Health Questionnaire (PHQ)‐2 and PHQ‐9. The bidirectional elimination was used to screen independent predictors of heart failure with depression symptoms. The least absolute shrinkage and selection operator (LASSO) optimized the predictor variables, and the prediction model was constructed. The model was internally validated by the bootstrap sampling method (Bootstrap), and its performance was assessed by discrimination and calibration. The mean age of patients with heart failure was 69.43 ± 12.15 years, and the proportion of males was 66.67%. The prevalence of depressive symptoms in hospitalized patients with heart failure was 46.83%, and the prevalence of moderate/severe depressive symptoms was 11.62%. Eighty cases (30.30%) were readmitted for heart failure, and 13 cases (4.92%) were all‐cause deaths. Depressive symptoms (HR = 2.43, 95% CI: 1.55–3.80) and the PHQ‐9 score (HR = 1.11, 95% CI: 1.06–1.16) were both independent risk factors for endpoint events (P < 0.001). For heart failure patients combined with depressive symptoms, obesity (OR = 0.27, 95% CI: 0.09–0.77, P = 0.015), N‐terminal brain natriuretic peptide precursor (NT‐proBNP) level (lnNT‐proBNP: OR = 1.55, 95% CI: 1.20–2.01, P < 0.001) and red blood cell distribution width (RDW) (OR = 1.26, 95% CI: 1.08–1.47, P = 0.004) were the independent factors. Six variables, including cardiovascular disease hospitalization history, obesity, renal insufficiency, NT‐proBNP level, neutrophil ratio and RDW, were included to construct the prediction model. The area under the curve (AUC) was 0.730 in the original data, and the calibration curve was approximately distributed along the reference line in Bootstrap (500 resamplings), indicating the high level of discrimination and calibration of this model. CONCLUSIONS: Depressive symptoms and the PHQ‐9 score are both independent risk factors for the prognosis of hospitalized patients with heart failure. In hospitalized patients with heart failure, the risk prediction model developed in this study has good predictive power for depressive symptoms.
format Online
Article
Text
id pubmed-9288805
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-92888052022-07-19 Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors Duan, Jiahao Huang, Kai Zhang, Xinying Wang, Ruting Chen, Zijun Wu, Zifeng Huang, Chaoli Yang, Chun Yang, Ling ESC Heart Fail Original Articles AIMS: This study aims to analyse the factors associated with prognosis in hospitalized patients with heart failure, particularly the role of depressive symptoms, and to develop a prediction model for depressive symptoms based on clinical characteristics in hospitalized patients with heart failure. METHODS AND RESULTS: Baseline information was collected at admission, and patients were followed up after discharge. The endpoint events were being hospitalized for heart failure or all‐cause death. Depressive symptoms were evaluated and defined via the Patient Health Questionnaire (PHQ)‐2 and PHQ‐9. The bidirectional elimination was used to screen independent predictors of heart failure with depression symptoms. The least absolute shrinkage and selection operator (LASSO) optimized the predictor variables, and the prediction model was constructed. The model was internally validated by the bootstrap sampling method (Bootstrap), and its performance was assessed by discrimination and calibration. The mean age of patients with heart failure was 69.43 ± 12.15 years, and the proportion of males was 66.67%. The prevalence of depressive symptoms in hospitalized patients with heart failure was 46.83%, and the prevalence of moderate/severe depressive symptoms was 11.62%. Eighty cases (30.30%) were readmitted for heart failure, and 13 cases (4.92%) were all‐cause deaths. Depressive symptoms (HR = 2.43, 95% CI: 1.55–3.80) and the PHQ‐9 score (HR = 1.11, 95% CI: 1.06–1.16) were both independent risk factors for endpoint events (P < 0.001). For heart failure patients combined with depressive symptoms, obesity (OR = 0.27, 95% CI: 0.09–0.77, P = 0.015), N‐terminal brain natriuretic peptide precursor (NT‐proBNP) level (lnNT‐proBNP: OR = 1.55, 95% CI: 1.20–2.01, P < 0.001) and red blood cell distribution width (RDW) (OR = 1.26, 95% CI: 1.08–1.47, P = 0.004) were the independent factors. Six variables, including cardiovascular disease hospitalization history, obesity, renal insufficiency, NT‐proBNP level, neutrophil ratio and RDW, were included to construct the prediction model. The area under the curve (AUC) was 0.730 in the original data, and the calibration curve was approximately distributed along the reference line in Bootstrap (500 resamplings), indicating the high level of discrimination and calibration of this model. CONCLUSIONS: Depressive symptoms and the PHQ‐9 score are both independent risk factors for the prognosis of hospitalized patients with heart failure. In hospitalized patients with heart failure, the risk prediction model developed in this study has good predictive power for depressive symptoms. John Wiley and Sons Inc. 2022-05-27 /pmc/articles/PMC9288805/ /pubmed/35620885 http://dx.doi.org/10.1002/ehf2.13993 Text en © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Duan, Jiahao
Huang, Kai
Zhang, Xinying
Wang, Ruting
Chen, Zijun
Wu, Zifeng
Huang, Chaoli
Yang, Chun
Yang, Ling
Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors
title Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors
title_full Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors
title_fullStr Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors
title_full_unstemmed Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors
title_short Role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors
title_sort role of depressive symptoms in the prognosis of heart failure and its potential clinical predictors
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9288805/
https://www.ncbi.nlm.nih.gov/pubmed/35620885
http://dx.doi.org/10.1002/ehf2.13993
work_keys_str_mv AT duanjiahao roleofdepressivesymptomsintheprognosisofheartfailureanditspotentialclinicalpredictors
AT huangkai roleofdepressivesymptomsintheprognosisofheartfailureanditspotentialclinicalpredictors
AT zhangxinying roleofdepressivesymptomsintheprognosisofheartfailureanditspotentialclinicalpredictors
AT wangruting roleofdepressivesymptomsintheprognosisofheartfailureanditspotentialclinicalpredictors
AT chenzijun roleofdepressivesymptomsintheprognosisofheartfailureanditspotentialclinicalpredictors
AT wuzifeng roleofdepressivesymptomsintheprognosisofheartfailureanditspotentialclinicalpredictors
AT huangchaoli roleofdepressivesymptomsintheprognosisofheartfailureanditspotentialclinicalpredictors
AT yangchun roleofdepressivesymptomsintheprognosisofheartfailureanditspotentialclinicalpredictors
AT yangling roleofdepressivesymptomsintheprognosisofheartfailureanditspotentialclinicalpredictors