Anhedonic Depression Is Not Associated With Risk of Recurrent Major Adverse Cardiac Events and All-Cause Mortality in Acute Coronary Syndrome Patients

2021 ◽  
Author(s):  
Gabriel J Sanchez ◽  
Jennifer A Sumner ◽  
Joseph E Schwartz ◽  
Matthew M Burg ◽  
Siqin Ye ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Depressive Symptoms ◽  
Major Adverse Cardiac Events ◽  
Self Report ◽  
Continuous Measure ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events ◽  
All Cause Mortality ◽  
Anhedonic Depression

Abstract Background Depression after acute coronary syndrome (ACS) is common and increases risks of adverse outcomes, but it remains unclear which depression features are most associated with major adverse cardiac events (MACE) and all-cause mortality (ACM). Purpose To examine whether a subtype of depression characterized by anhedonia and major depressive disorder (MDD) predicts 1-year MACE/ACM occurrence in ACS patients compared to no MDD history. We also consider other depression features in the literature as predictors. Methods Patients (N = 1,087) presenting to a hospital with ACS completed a self-report measure of current depressive symptoms in-hospital and a diagnostic interview assessing MDD within 1 week post-hospitalization. MACE/ACM events were assessed at 1-, 6-, and 12-month follow-ups. Cox regression models were used to examine the association of the anhedonic depression subtype and MDD without anhedonia with time to MACE/ACM, adjusting for sociodemographic and clinical covariates. Results There were 142 MACE/ACM events over the 12-month follow-up. The 1-year MACE/ACM in patients with anhedonic depression, compared to those with no MDD, was somewhat higher in an age-adjusted model (hazard ratio [HR] = 1.63, p = .08), but was not significant after further covariate adjustment (HR = 1.24, p = .47). Of the additional depression features, moderate-to-severe self-reported depressive symptoms significantly predicted the risk of MACE/ACM, even in covariate-adjusted models (HR = 1.72, p = .04), but the continuous measure of self-reported depressive symptoms did not. Conclusion The anhedonic depression subtype did not uniquely predict MACE/ACM as hypothesized. Moderate-to-severe levels of total self-reported depressive symptoms, however, may be associated with increased MACE/ACM risk, even after accounting for potential sociodemographic and clinical confounders.

scholarly journals Association between education and major adverse cardiac events among patients with acute coronary syndrome in the Arabian Gulf

2019 ◽  
Vol 4 (1) ◽  
pp. e001278 ◽  
Author(s):  
Ibrahim Al-Zakwani ◽  
Ruth M Mabry ◽  
Mohammad Zubaid ◽  
Alawi A Alsheikh-Ali ◽  
Wael Almahmeed ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Formal Education ◽  
Arabian Gulf ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Gulf Countries ◽  
Low Health Literacy ◽  
Adverse Cardiac Events ◽  
All Cause Mortality

IntroductionThe objective of this study was to evaluate the association between education and major adverse cardiac events in patients with acute coronary syndrome (ACS) in the Arabian Gulf.MethodsData were analysed from 3874 consecutive patients diagnosed with ACS admitted to 29 hospitals in four Arabian Gulf countries from January 2012 to January 2013. Education was defined as any type of formal training from primary school and above. MACE included stroke/transient ischaemic attack (TIA), myocardial infarction (MI), all-cause mortality and readmissions for cardiac reasons.ResultsThe overall mean age was 60±13 years and 67% (n=2579) were men. A total of 53% (n=2039) of the patients had some form of school education. Adjusting for demographic and clinical characteristics as well as socioeconomic measures (insurance type and employment), at 12-month follow-up, educated patients were significantly less likely to have had MACE (adjusted OR (aOR): 0.55; 95% CI 0.44 to 0.68; p<0.001) than those with no formal education. The lower rate of events was also consistent across all MACE components: stroke/TIA (aOR: 0.56; 95% CI 0.33 to 0.94; p=0.030), MI (aOR: 0.58; 95% CI 0.38 to 0.86; p=0.008), all-cause mortality (aOR: 0.58; 95% CI 0.39 to 0.87; p=0.009) and readmissions for cardiac reasons (aOR: 0.61; 95% CI 0.48 to 0.77; p<0.001). MACE outcomes were consistent across men and women and across countries.ConclusionsEducation was associated with lower MACE events in patients with ACS in the Arabian Gulf. Interventions promoting healthy lifestyles and management of clinical risk factors for patients with low health literacy are urgently required.

Diagnostic and prognostic impact of circulating microRNA-208b and microRNA-499 in patients with acute coronary syndrome

2020 ◽  
Vol 14 (2) ◽  
pp. 87-95
Author(s):  
Wei Wang ◽  
Tai Li ◽  
Lei Gao ◽  
Yang Li ◽  
Ying Sun ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Major Adverse Cardiac Events ◽  
Circulating Microrna ◽  
Prognostic Impact ◽  
Cardiac Events ◽  
Primary Analysis ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events

Aim: This study aimed to investigate the correlation between the expression of circulating miR-208b and miR-499 and acute coronary syndrome (ACS) patients. Materials & methods: A total of 160 consecutive patients with ACS and 48 healthy control subjects were enrolled for primary analysis. The ACS patients (n = 160) were followed up for 6 months for further analysis regarding major adverse cardiac events. Results: Area under the curve values of miR-208b and miR-499 for predicting ACS were 0.910 and 0.851 (p < 0.001, respectively). Cox proportional hazards regression analysis revealed that miR-208b but not miR-499 was an independent predictor of major adverse cardiac events. Conclusion: Circulating miR-208b and miR-499 could be considered as diagnostic or prognostic biomarkers for patients with ACS.

Referral decisions based on a prehospital HEART score in suspected non-ST-elevation acute coronary syndrome: design of the FamouS Triage 3 study

2020 ◽  
Vol 16 (4) ◽  
pp. 217-226
Author(s):  
Dominique N van Dongen ◽  
Rudolf T Tolsma ◽  
Marion J Fokkert ◽  
Erik A Badings ◽  
Aize van der Sluis ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Heart Score ◽  
Coronary Syndrome ◽  
Referral Decisions ◽  
Adverse Cardiac Events ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome

Background: It is not yet investigated whether referral decisions based on prehospital risk stratification of non-ST-elevation Acute Coronary Syndrome (NSTE-ACS) by the complete History, ECG, Age, Risk factors and initial Troponin (HEART) score are feasible and safe. Hypothesis: Implementation of referral decisions based on the prehospital acquired HEART score in patients with suspected NSTE-ACS is feasible and not inferior to routine management in the occurrence of major adverse cardiac events within 45 days. Study design & methods: FamouS Triage 3 is a feasibility study with a before–after sequential design. The aim is to assess whether prehospital HEART-score management including point-of-care troponin measurement is feasible and noninferior to routine management. Primary end point is the occurrence of major adverse cardiac events within 45 days. Conclusion: If referral decisions based on prehospital acquired risk stratification are feasible and noninferior this can become the new prehospital management in suspected NSTE-ACS.

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