Abstract P326: Impact of Cardiac Rehabilitation on Depressive Symptomatology in Female Cardiac Patients

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Bharathi Reddy ◽  
Kiseok Lee ◽  
Nancy Rullo ◽  
Donna Cheslik Candy ◽  
John P Nicholson
Keyword(s):  
New York ◽  
Depressive Symptoms ◽  
Cardiac Rehabilitation ◽  
Depressive Symptomatology ◽  
The United States ◽  
Cardiac Patients ◽  
Female Patients ◽  
Enrollment Rates ◽  
Male Patients ◽  
Artery Disease

BACKGROUND: Coronary artery disease (CAD) is the leading cause of mortality in women and is responsible for more than 500,000 lives each year in the United States. Depression and depressive symptomatology in healthy subjects increases cardiovascular mortality in both men and women and its prevalence is exponentially rising in women. Research suggests that participation in a cardiac rehabilitation (CR) program reduces depression. Unfortunately studies have shown that CR is widely underutilized, particularly with significantly lower CR enrollment rates among women. HYPOTHESIS: The aim of this study was to demonstrate the effect of CR in the improvement of depressive symptoms in female cardiac patients after a cardiovascular event enrolled at the Cardiac Health Center (CHC) New York Hospital Queens (NYHQ). METHODS: The study sample comprised of 295 patients who completed 36 visits of CR at CHC NYHQ from 2007-2009. Out of 295 patients (age 66.85 ±10.64), 214 are males (71%) and 81 are females (29%). Mood scores were assessed using the PHQ-9 at the initial visit and again upon completion of the CR program. Of the 81 female patients enrolled, 31 female patients had documented pre and post CR-PHQ scores and of the 214 male patients enrolled, 81male patients had documented pre and post CR-PHQ scores. Using paired t test average mean difference in mood scores was tested. RESULTS: There was a significant decrease in mood scores in female patients (7.57 ± 5.18 to 3.11 ± 4.00, Δ 4.45 p= 0.00) compared to male patients (5.72 ± 5.19 to 2.37 ± 3.95 Δ 3.34 p = 0.00) after the completion of CR. CONCLUSION: The result of this study confirms that both male and female cardiac patients demonstrated significant reduction in depressive symptoms upon completion of CR. Female cardiac patients reported higher levels of depressive symptoms than male cardiac patients at the beginning of CR and exhibited a significant decrease in mood scores at the end of CR. This evidence supports that CR is an effective treatment in the reduction of depressive symptoms among female cardiac patients. Future studies are needed to establish the relationship among gender, CR, and depression. Clearly this is a complex issue and further efforts are needed to institute strategies to increase participation rates among female cardiac patients.

scholarly journals Medicine-based evidence: the case of antidepressants in patients with coronary artery disease

2018 ◽  
Vol 28 (1) ◽  
pp. 18-20
Author(s):  
C. Barbui ◽  
G. Ostuzzi
Keyword(s):  
Coronary Artery Disease ◽  
Depressive Symptoms ◽  
Coronary Artery ◽  
Depressive Symptomatology ◽  
Rehabilitation Program ◽  
Everyday Clinical Practice ◽  
Production Of Knowledge ◽  
Antidepressant Use ◽  
Artery Disease ◽  
Harmful Effects

AbstractIn individuals with coronary artery disease and concurrent depressive symptomatology, the evidence on the beneficial and harmful effects of antidepressants is very limited. Recently, a study was carried out to describe depressive symptoms and the treatments provided under real-world circumstances to cardiac patients who entered the Mayo Clinic cardiac rehabilitation program. Antidepressant use was associated with reductions in depressive symptoms, but also with poorer cardiovascular outcomes. In this commentary, the results of this study are discussed in view of their clinical implications for everyday clinical practice and for the production of knowledge.

scholarly journals Depression: a common comorbidity in women with rheumatoid arthritis—results from an Austrian cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033958 ◽  
Author(s):  
Judith Sautner ◽  
Rudolf Puchner ◽  
Alois Alkin ◽  
Herwig Pieringer
Keyword(s):  
Rheumatoid Arthritis ◽  
Depressive Symptoms ◽  
Disease Activity ◽  
Depressive Symptomatology ◽  
Activity Index ◽  
Occupational Status ◽  
Assessment Tools ◽  
Alcoholic Beverages ◽  
Secondary Outcome ◽  
Female Patients

ObjectivesPrevious research showed that depression is common in rheumatoid arthritis (RA). However, the prevalence very much depends on different assessment tools and sociocultural differences, respectively. The main study aim and research question was to investigate the proportion of depressive symptoms in Austrian female patients with RA.SettingA nationwide multicentre study with seven secondary care centres all over Austria (hospital-based rheumatological outpatient clinics and private practices).Participants319 patients with RA and 306 healthy controls (HCO), all female Caucasians, were asked to complete a Beck’s Depression Inventory–Fast Screen (BDI-FS). Patients and HCO were ≥18 years. Patients had to fulfil the 2010 classification criteria for RA. In addition, disease activity, disability, medication, drinking of alcoholic beverages, smoking and occupational status were evaluated.Primary and secondary outcome measuresA BDI-FS cut-off value of ≥4, per definition, indicates the presence of a depressive symptomatology.ResultsThe return rate of questionnaires was high: 235/319 (73.7%) in patients with RA and 180/306 (58.8%), ending up with 392 complete questionnaires from 223 patients with RA (69.9%) and 169 HCO (55.2%). The BDI-FS was significantly higher in patients with RA (median BDI-FS 2 (IQR 0–4) vs median 1 (IQR 0–2) in HCO, p<0.001). BDI-FS scores from ≥4, which by definition indicate depression, were found in 29.6% of patients with RA and 12.4% of HCO (p<0.001). Depressive symptoms were strongly associated with disease activity (Clinical Disease Activity Index, p<0.001) and disability (Health Assessment Questionnaire, p<0.005). No association of depressive symptoms with age, alcohol consumption, smoking, occupational status or use of medication was found.ConclusionsOne-third of female patients with RA showed depressive symptoms. Depression was significantly higher in female patients with RA than in female HCO and was strongly associated with disease activity and disability. It would be of interest to address the same question in male participants.

scholarly journals Adipokine profi le in patients with ischemic heart disease in stenting of the coronary arteries: contribution of changes in psychoemotional status

2020 ◽  
Vol 11 (2) ◽  
pp. 62-70
Author(s):  
A. O. Lobe ◽  
D. N. Ivanchenko ◽  
N. P. Dorofeeva ◽  
L. P. Sizyakina ◽  
M. V. Kharitonova ◽  
...  
Keyword(s):  
Heart Disease ◽  
Depressive Symptoms ◽  
Stable Coronary Artery Disease ◽  
Coronary Intervention ◽  
Affective Symptoms ◽  
Stable Coronary Heart Disease ◽  
Functional Classes ◽  
Male Patients ◽  
Artery Disease ◽  
Subclinical Symptoms

Objective: to investigate the adipokine profile’s changes, depending on the presence or absence the signs of psychoemotional disorders in the form of associated affective symptoms in patients with stable coronary heart disease (CHD) without diagnosed carbohydrate metabolism’s disorders undergoing routine percutaneous coronary intervention (PCI) with stenting, and also to assess their relationship with clinical outcomes within 1 year after hospitalization.Materials and methods: the study included 20 male patients with stable angina pectoris of functional classes II – III, hospitalized for coronary stenting. The severity of affective symptoms were being assessed. The levels markers of adiponectin, leptin, resistin in the blood plasma were determined before PCI and on the 3rd day after the operation.Results: patients with stable coronary artery disease had increase in resistin concentrations and a decrease in adiponectin levels compared with reference. The change of psychoemotional status was accompanied by an initially more expressed increase in the concentrations of plasma resistin. The resistin’s level has been signifi cantly increased on the third day after PCI in patients without depressive symptoms. The dynamics of depressive symptoms hasn’t observed during the year. Clinically unfavorable outcomes, including stent’s restenosis, re-hospitalization, and the increase in angina attacks, were recorded more oft en in patients with subclinical symptoms of depression that persisted throughout the observation period.Conclusions: the factors that negatively aff ected the cardiac prognosis were the disorders of the psychoemotional status and adipokine’s changes, including аn increasе of resistin’s and a decrease of adiponectin’s levels.

scholarly journals Polybrominated diphenyl ether serum concentrations and depressive symptomatology in pregnant African American women

2020 ◽  
Author(s):  
A. Mutic ◽  
D. Barr ◽  
V. Hertzberg ◽  
A. Dunlop ◽  
P. Brennan ◽  
...  
Keyword(s):  
African American ◽  
Depressive Symptoms ◽  
High Risk ◽  
Pregnant Women ◽  
Depressive Symptomatology ◽  
The United States ◽  
The Body ◽  
Chemical Degradation ◽  
Weighted Estimate ◽  
Environmental Toxicants

ABSTRACTBackgroundPolybrominated diphenyl ethers (PBDEs) are lipophilic, persistent endocrine disrupting chemicals often used as flame retardants in products that were widely produced in the United States until 2004. The potential for environmental toxicants such as PBDEs to disrupt normal neuroendocrine pathways resulting in depression and other neurological symptoms has been largely understudied. This study examined whether PBDE exposure in pregnant women was associated with antenatal depressive symptomatology.MethodsThis study is part of a larger longitudinal pregnancy and birth cohort study. Data were collected from 193 African American pregnant women at 8-14 weeks gestation. Serum PBDEs were analyzed using gas chromatography-tandem mass spectrometry. The Edinburgh Depression Scale (EDS) was used to identify depressive symptoms experienced in the last seven days prior to biosampling. The dichotomous depression variable was used to explore varying high-risk EDS cutoffs and illustrated with receiver operating characteristic curves. Logistic regression models were constructed to investigate associations with antenatal depression and a weighted quantile sum (WQS) index was calculated to account for the mixture of PBDE congeners.ResultsOf the total sample, 52 women (26.9%) were categorized as having a high risk of depression. PBDE congeners −47, −99, and −100 were detected in 50% or more of the samples tested. BDE-47 was positively associated with depressive symptoms (β =2.36, p=0.05). The risk of being mild to moderately depressed increased by a factor of 4.52 for BDE-47 (CI 1.50, 13.60) and 1.58 for BDE-99 (CI 1.08, 2.29). The WQS index, a weighted estimate of the body burden of the congener mixture was positively associated with a higher risk of mild to moderate depression using an EDS cutoff ≥10 (OR=2.93; CI 1.18, 7.82).ConclusionBDE-47 and −99 exposures are significantly associated with depressive symptomatology in a pregnant cohort. These exposures will likely continue for years due to slow chemical degradation. Interventions should focus on PBDE mitigation to reduce toxic neuroendocrine effects on vulnerable pregnant women.

Underdiagnosis of Depression in Patients with Coronary Artery Disease: The Role of Nonspecific Symptoms

1992 ◽  
Vol 22 (3) ◽  
pp. 221-229 ◽  
Author(s):  
Kenneth E. Freedland ◽  
Patrick J. Lustman ◽  
Robert M. Carney ◽  
Barry A. Hong
Keyword(s):  
Coronary Artery Disease ◽  
Depressive Symptoms ◽  
Coronary Artery ◽  
Major Depression ◽  
Beck Depression Inventory ◽  
Cardiac Patients ◽  
Depression Symptoms ◽  
Artery Disease

Objective: To determine whether the underdiagnosis of major depression (MD) in patients with coronary artery disease (CAD) may be explained by low specificity and mild severity of depressive symptoms in affected patients. Method: The Beck Depression Inventory (BDI) was used to assess depression symptoms in thirty-one patients with both CAD and MD, and eighty-three patients with CAD but without MD. Results: Only ten (48%) of the symptoms were significantly more common in the MD than in the non-MD group, and nine symptoms were present in at least 20 percent of both groups. Of these nine nonspecific symptoms, only one (insomnia) was more severe in the MD patients than in the non-MD group ( p < .006). When all twenty-one symptoms were rank ordered by frequency, the most common symptoms in the MD group were also the most common in the non-MD group ( r = .91, p < .001). Conclusions: The symptoms of major depression were found to be relatively mild and nonspecific in patients with CAD. This may help to explain why depression is underdiagnosed in cardiac patients.

scholarly journals Gender Predliction and Confunding Factors Affecting Pre Hospital Delay Among Acute Myocardial Infraction Patients.

2020 ◽  
Vol 9 (1) ◽  
pp. ME10-ME12
Author(s):  
Jayesh Sharma ◽  
Avanish kumar Bhardwaj
Keyword(s):  
Health Care ◽  
Care Setting ◽  
Health Care Setting ◽  
Factors Affecting ◽  
Golden Hour ◽  
Female Patients ◽  
Myocardial Infraction ◽  
Male Patients ◽  
Males And Females ◽  
Artery Disease

Background: Acute Myocardial Infarction (AMI) is a serious and life-threatening manifestation of coronary artery disease (CAD) affecting both males and females, which need immediate management. The present study was aimed to assess the gender difference and factors affecting pre-hospital delay among patients with AMI.Subjects and Methods:The 291 patients admitted with AMI from01-01-2018 to 31-12-2018 were studied. A descriptive comparative design was adopted for the study. Socio personal and clinical variables of the subjects were assessed. Pre-hospital delay was measured in terms of time from the onset of symptoms till the patient reaches a health care setting. One hour after the onset of symptom of AMI was considered as the Golden hour. Data was analyzed using SPSS 20.0 software.Results:Out of the 291 patients with AMI (146 males and 145 females), only 32.4% of males and 24.1% of females reached a health care setting within 1 hr of onset of symptoms. 35.2% of male patients and 43.5% of female patients reached the health care setting only after 6 hrs of onset of symptoms. Among the male patients, pre hospital delay was significantly associated with place of onset of symptoms (p<0.05), presence of someone with the patient at the time of onset of symptoms (p<0.05), and perception of symptoms developed, as an emergency (P<0.001). Whereas in female patients, significant association was observed in pre hospital delay with age of the patient (p<0.05), nature of the first symptom experienced (P<0.05) and perception of symptoms developed as an emergency (p<0.001).Conclusion: Our study shows the existence of pre hospital delay among patients with AMI in both males and females. The factors affecting pre hospital delay vary between males & females.

scholarly journals Determinants of Hospital Variation in Cardiac Rehabilitation Enrollment During Coronary Artery Disease Episodes of Care

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
Michael P. Thompson ◽  
Jessica M. Yaser ◽  
Hechuan Hou ◽  
John D. Syrjamaki ◽  
Alphonse DeLucia ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Treatment Strategy ◽  
Treatment Strategies ◽  
Hospital Level ◽  
Hospital Variation ◽  
Enrollment Rates ◽  
Episodes Of Care ◽  
Artery Disease

Background: Cardiac rehabilitation (CR) is associated with improved outcomes for patients with coronary artery disease (CAD). However, CR enrollment remains low and there is a dearth of real-world data on hospital-level variation in CR enrollment. We sought to explore determinants of hospital variability in CR enrollment during CAD episodes of care: medical management of acute myocardial infarction (AMI-MM), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). Methods: A cohort of 71 703 CAD episodes of care were identified from 33 hospitals in the Michigan Value Collaborative statewide multipayer registry (2015 to 2018). CR enrollment was defined using professional and facility claims and compared across treatment strategies: AMI-MM (n=18 678), PCI (n=41 986), and CABG (n=11 039). Hierarchical logistic regression was used to estimate effects of predictors and hospital risk-adjusted rates of CR enrollment. Results: Overall, 20 613 (28.8%) patients enrolled in CR, with significant differences by treatment strategy: AMI-MM=13.4%, PCI=29.0%, CABG=53.8% ( P <0.001). There were significant differences in CR enrollment across age groups, comorbidity status, and payer status. At the hospital-level, there was over 5-fold variation in hospital risk-adjusted CR enrollment rates (9.8%–51.6%). Hospital-level CR enrollment rates were highly correlated across treatment strategy, with the strongest correlation between AMI-MM versus PCI (R 2 =0.72), followed by PCI versus CABG (R 2 =0.51) and AMI-MM versus CABG (R 2 =0.46, all P <0.001). Conclusions: Substantial variation exists in CR enrollment during CAD episodes of care across hospitals. However, within-hospital CR enrollment rates were significantly correlated across all treatment strategies. These findings suggest that CR enrollment during CAD episodes of care is the product of hospital-specific rather than treatment-specific practice patterns.

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