Depression Linked to Functional Status in Coronary Artery Disease

Patients with class II, III, or IV functional status had an increased risk of hospitalization for heart failure.
Patients with class II, III, or IV functional status had an increased risk of hospitalization for heart failure.

HealthDay News — For patients with stable coronary artery disease, depressive symptoms and cardiac disease severity independently affect patient-reported functional status, according to a study published in the Nov. 1 issue of The American Journal of Cardiology.

David W. Schopfer, MD, from the University of California in San Francisco, and colleagues compared the associations of depressive symptoms and objective measures of cardiac disease severity with perceived functional status in 1023 patients with stable coronary artery disease. The extent to which patient-reported functional status was influenced by depressive symptoms was assessed. Perceived functional status was then evaluated as a predictor of subsequent cardiovascular hospitalizations during 8.8 years of follow-up.

The researchers found that, compared to patients without depressive symptoms, those with depressive symptoms were more likely to report poor functional status (44% vs 17%; P < 0.001). Independent predictors of poor functional status were depressive symptoms, poor exercise capacity, and history of heart failure, after adjustment for traditional risk factors and comorbid conditions (odds ratios, 2.68, 2.30, and 1.61, respectively). After adjustment for confounding variables, compared with patients who had class I functional status, those with class II and class III or IV functional status had an increased rate of hospitalization for heart failure (hazard ratios, 1.96 and 2.04, respectively).

"Perceived functional status may be as strongly influenced by depressive symptoms as it is by cardiovascular disease severity," the authors wrote.

Reference

Schopfer DW, Regan M, Heidenreich PA, Whooley MA. Depressive Symptoms, Cardiac Disease Severity, and Functional Status in Patients With Coronary Artery Disease (from the Heart and Soul Study). Am J Cardiol. 2016;118(9):1287-1292. doi:10.1016/j.amjcard.2016.07.062.

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