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| Publications [#197743] of Daniel B. Mark
Papers Published
- JC Barefoot, MJ Helms, DB Mark, JA Blumenthal, RM Califf, TL Haney, CM O'Connor, IC Siegler, RB Williams, Depression and long-term mortality risk in patients with coronary artery disease.,
The American journal of cardiology, vol. 78 no. 6
(September, 1996),
pp. 613-7, ISSN 0002-9149
(last updated on 2011/11/29)
Abstract:
Previous research has established that patients with coronary artery disease (CAD) have an increased risk of death if they are depressed at the time of hospitalization. Follow-up periods have been short in these studies; therefore, the present investigation examined this phenomenon over an extended period of time. Patients with established CAD (n = 1,250) were assessed for depression with the Zung Self-Rating Depression Scale (SDS) and followed for subsequent mortality. Follow-up ranged up to 19.4 years. SDS scores were associated with increased risk of subsequent cardiac death (p = 0.002) and total mortality (p < 0.001) after controlling for initial disease severity and treatment. Patients with moderate to severe depression had a 69% greater odds of cardiac death and a 78% greater odds of mortality from all causes than nondepressed patients. Increased risk was not confined to the initial months after hospitalization. Patients with high SDS scores at baseline still had a higher risk of cardiac death > 5 years later (p < 0.005). Compared with the nondepressed, patients with moderate to severe depression had an 84% greater risk 5 to 10 years later and a 72% greater risk after > 10 years. Patients with mild depression had intermediate levels of risk in all models. The heightened long-term risk of depressed patients suggests that depression may be persistent or frequently recurrent in CAD patients and is associated with CAD progression, triggering of acute events, or both.
Keywords:
Coronary Disease • Depression • Depressive Disorder • Female • Follow-Up Studies • Humans • Male • Middle Aged • Risk • Severity of Illness Index • Survival Analysis • complications* • mortality*
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