Comorbidity of depression and anxiety leads to a poor prognosis following angina pectoris patients: a prospective study

Abstract Background Depression and anxiety are two common mood problems among patients with cardiovascular disease (CVD) and are associated with poor cardiac prognoses. The comorbidity of depression and anxiety is considered to be a more severe psychological status than non-comorbid mood disorders. However, little is known about the relationship between depression or anxiety and noncardiac readmission. We conducted a prospective study on the prognostic impact of depression, anxiety, and the comorbidity of the two among angina pectoris (AP) patients. Method In this prospective study, 443 patients with AP were included in the analysis. Follow-up assessments were performed 1 year, and 2 years after patient discharges. Clinical outcomes of interest included noncardiac readmission, major adverse cardiovascular events (MACEs), and composite events. Depression and anxiety symptom scores derived from the patient health questionnaire-9 (PHQ-9) and generalised anxiety disorder-7 (GAD-7) questionnaire were used to assess mood symptoms at baseline. Participants with symptom scores of ≥10 on both the depression and anxiety questionnaires formed the clinical comorbidity subgroup. We used multivariable Cox proportional hazards models to evaluate the impact of individual mood symptom and comorbidity on clinical outcomes. Results Among all the AP patients, 172 (38. 9%) were determined to have depression symptoms, 127 (28.7%) patients had anxiety symptoms and 71 (16.0%) patients suffered from their comorbidity. After controlling covariates, we found that patients who endured clinical depression (hazard ratio [HR] = 2.38, 95% confidence interval [CI] 1.06–5.33, p = 0.035) and anxiety ([HR] 2.85, 95% [CI] 1.10–7.45, p = 0.032) had a high risk of noncardiac readmission. Compared to participants with no mood symptoms, those with clinical comorbidity of depression and anxiety presented a greater risk of noncardiac readmission ([HR] 2.91, 95% [CI] 1.03–8.18, p = 0.043) MACEs ([HR] 2.38, 95% [CI] 1.11–5.10, p = 0.025) and composite event ([HR] 2.52, 95% [CI] 1.35–4.69, p = 0.004). Conclusion Depression and anxiety were found to have predictive value for noncardiac readmission among patients with AP. Furthermore, prognoses were found to be worse for patients with comorbidity of depression and anxiety than those with single mood symptom. Additional attention needs to be focused on the initial identification and long-term monitoring of mood symptom comorbidity.

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Comorbidity of Depression and Anxiety Leads to A Poor Prognosis Following Angina Pectoris Patients: A Prospective Study

10.21203/rs.3.rs-112803/v1 ◽

2020 ◽

Author(s):

Bingqing Bai ◽

Han Yin ◽

Lan Guo ◽

Huan Ma ◽

Haochen Wang ◽

...

Keyword(s):

Angina Pectoris ◽

Prospective Study ◽

Clinical Outcomes ◽

Psychiatric Symptoms ◽

Depression Symptoms ◽

Prognostic Impact ◽

Depression And Anxiety ◽

Symptom Scores ◽

A Prospective Study ◽

The Impact

Abstract Background: Depression and anxiety are two common psychiatric problems in patients with cardiovascular disease (CVD) and are associated with poor cardiac prognosis. The comorbidity of depression and anxiety is considered to be a more severe psychological status than non-comorbid psychiatric disorders. However, little is known about the relationship between depression or anxiety and noncardiac readmission. We conducted a prospective study on the prognostic impact of depression, anxiety, and comorbidity in angina pectoris (AP) patients. Method: In this prospective study, 443 patients with AP were included in the analysis. Follow-up assessments were performed 1 year, and 2 years after patient discharges. Clinical outcomes of interest included readmission, major cardiovascular event (MACE), and composite events. Depression and anxiety symptom scores derived from the patient health questionnaire-9 (PHQ-9) and generalised anxiety disorder-7 (GAD-7) questionnaire were used to assess mood symptoms. Participants with symptom scores of ≥ 10 on both questionnaires formed the comorbidity group. Using multivariable Cox proportional hazards models to evaluate the impact of psychiatric symptoms on clinical outcomes.Results: Among all the AP patients, 271 (61.2%) had non-depression symptoms and 172 (38. 9%) were determined to have depression symptoms. As for anxiety symptoms, 316 (71.3%), and 127 (28.7%) patients had non-anxiety, and anxiety respectively. After controlling covariates, we found that patients who endured clinical depression (hazard ratio [HR] = 2.12, 95% confidence interval [CI] 1.04–4.31, p=0.038) and anxiety ([HR] 2. 65, 95% [CI] 1.12–6.30, p=0.027) had a high risk of noncardiac readmission. Compared to participants with no psychiatric symptoms, those with comorbidities of depression and anxiety presented a greater risk of MACEs ([HR] 2.38, 95% [CI] 1.11–5.10, p=0.025) and noncardiac readmission ([HR] 2.91, 95% [CI] 1.03–8.18, p=0.043) while the single-symptom group did not show any significances on all the events.Conclusion: Depression and anxiety had predictive value for noncardiac readmission among patients with AP. Furthermore, prognoses were found to be worse for patients with comorbidities of depression and anxiety than those with single psychiatric symptoms. Additional attention needs to be focused on the initial identification and long-term monitoring of psychiatric comorbidity.

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ENDOSCOPIC AND CLINICAL OUTCOMES IN CD PATIENTS: RESULTS OF A PROSPECTIVE STUDY

10.1055/s-0039-1681800 ◽

2019 ◽

Author(s):

M State ◽

T Voiosu ◽

A Bengus ◽

B Mateescu

Keyword(s):

Prospective Study ◽

Clinical Outcomes ◽

A Prospective Study

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Baseline and Kinetic Circulating Tumor Cell Counts Are Prognostic Factors in a Prospective Study of Metastatic Colorectal Cancer

Diagnostics ◽

10.3390/diagnostics11030502 ◽

2021 ◽

Vol 11 (3) ◽

pp. 502

Author(s):

Virgílio Souza e Silva ◽

Emne Ali Abdallah ◽

Angelo Borsarelli Carvalho de Brito ◽

Alexcia Camila Braun ◽

Milena Shizue Tariki ◽

...

Keyword(s):

Colorectal Cancer ◽

Drug Resistance ◽

Prospective Study ◽

Metastatic Colorectal Cancer ◽

Clinical Outcomes ◽

Predictive Biomarkers ◽

Multi Drug Resistance ◽

Cell Counts ◽

Potential Clinical Benefit ◽

A Prospective Study

The discovery of predictive biomarkers in metastatic colorectal cancer (mCRC) is essential to improve clinical outcomes. Recent data suggest a potential role of circulating tumor cells (CTCs) as prognostic indicators. We conducted a follow-on analysis from a prospective study of consecutive patients with mCRC. CTC analysis was conducted at two timepoints: baseline (CTC1; before starting chemotherapy), and two months after starting treatment (CTC2). CTC isolation/quantification were completed by ISET® (Rarecells, France). CTC expressions of drug resistance-associated proteins were evaluated. Progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan–Meier method. Seventy-five patients were enrolled from May 2012 to May 2014. A CTC1 cut-off of >1.5 CTCs/mL was associated with an inferior median OS compared to lower values. A difference of CTC2−CTC1 > 5.5 CTCs/mL was associated with a reduced median PFS. By multivariate analysis, CTC1 > 1.5 CTCs/mL was an independent prognostic factor for worse OS. Multi-drug resistance protein-1 (MRP-1) expression was associated with poor median OS. CTC baseline counts, kinetics, and MRP-1 expression were predictive of clinical outcomes. Larger studies are warranted to explore the potential clinical benefit of treating mCRC patients with targeted therapeutic regimens guided by CTC findings.

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