Depression Linked to Poor Outcomes in Heart Patients

Studies associate depression with increased angina in ischemia; death in a-fib and heart failure

01 july 2009-- In heart patients, depression is significantly associated with an increased risk of angina and cardiovascular mortality, according to two studies published online June 29 in Circulation.

In one study, Suzanne V. Arnold, M.D., of Saint Luke's Mid America Heart Institute in Kansas City, Mo., and colleagues used the Seattle Angina Questionnaire to assess four-week angina frequency in 788 ischemic heart disease patients who underwent imaging studies. Their adjusted analysis showed a significant association between increasing angina and a history of coronary revascularization, anxiety, and depression (odds ratios, 2.24, 4.72, and 3.12, respectively).

In a second study, Nancy Frasure-Smith, Ph.D., of the Montreal Heart Institute in Canada, and colleagues assessed 974 patients with atrial fibrillation and heart failure, 32 percent of whom had elevated depression scores. After a mean follow-up of 39 months, they found that elevated depression scores were significantly associated with an increased risk of cardiovascular mortality (adjusted hazard ratio, 1.57).

"These results support the study of angina treatment strategies that aim to reduce psychosocial distress in conjunction with efforts to lessen myocardial ischemia," Arnold and colleagues conclude.

One author of the first study reported ownership of the copyright to the Seattle Angina Questionnaire. Two of the authors of the second study reported financial relationships with the pharmaceutical industry.

Abstract - Arnold
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Abstract - Frasure-Smith
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