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Ventricular tachyarrhythmias and mortality in patients with an implantable cardioverter defibrillator: impact of depression in the MIDAS cohort

(2014) PSYCHOSOMATIC MEDICINE. 76(1). p.58-65
Author
Organization
Abstract
Objective: We examined whether depression is independently associated with implantable cardioverter defibrillator (ICD) therapy for ventricular tachyarrhythmias and mortality. Methods: A cohort of 430 consecutive patients with a first-time ICD (79% men; mean [standard deviation] age = 57.8 [12.1] years) completed the Hospital Anxiety and Depression Scale 1 day before implantation. During follow-up, the ICD was interrogated at 3-month intervals. Cox proportional hazard regression analyses were used to examine the impact of depression on time to first appropriate ICD therapy and all-cause mortality during a median follow-up period of 3.8 years. Results: Of all patients, 108 (25.1%) were depressed. Depression was not associated with time to first appropriate ICD therapy (unadjusted hazard ratio [HR] = 1.07, 95% confidence interval [CI] = 0.73-1.56). However, depression was associated with an increased risk for all-cause mortality (unadjusted HR = 2.18, 95% CI = 1.36-3.49). Depression remained independently associated with all-cause mortality (HR = 1.94, 95% CI = 1.06-3.54, p = .031), after adjusting for demographic and clinical characteristics. Patients who remained depressed during the first 3 months after implantation were at greatest risk for dying (HR = 2.88, 95% CI = 1.29-6.45, p = .010). Conclusions: The current study showed that depression at the time of implant is not associated with time to first appropriate ICD therapy but almost doubled the risk for all-cause mortality in patients with an ICD. Patients with persistent depression during the first 3 months after implantation face the greatest risk of dying. Current evidence indicates that multifactorial interventions are likely to be the most successful in terms of reducing distress. Whether this translates into enhanced survival has yet to be determined.
Keywords
depression, ventricular tachyarrhythmias, implantable cardioverter defibrillator, mortality, CORONARY-HEART-DISEASE, CARDIAC RESYNCHRONIZATION THERAPY, ACUTE MYOCARDIAL-INFARCTION, REHABILITATION PROGRAM, HOSPITAL ANXIETY, RATE TURBULENCE, 1ST YEAR, RISK, FAILURE, ICD

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MLA
Mastenbroek, Mirjam H et al. “Ventricular Tachyarrhythmias and Mortality in Patients with an Implantable Cardioverter Defibrillator: Impact of Depression in the MIDAS Cohort.” PSYCHOSOMATIC MEDICINE 76.1 (2014): 58–65. Print.
APA
Mastenbroek, M. H., Versteeg, H., Jordaens, L., Theuns, D. A., & Pedersen, S. S. (2014). Ventricular tachyarrhythmias and mortality in patients with an implantable cardioverter defibrillator: impact of depression in the MIDAS cohort. PSYCHOSOMATIC MEDICINE, 76(1), 58–65.
Chicago author-date
Mastenbroek, Mirjam H, Henneke Versteeg, Luc Jordaens, Dominic AMJ Theuns, and Susanne S Pedersen. 2014. “Ventricular Tachyarrhythmias and Mortality in Patients with an Implantable Cardioverter Defibrillator: Impact of Depression in the MIDAS Cohort.” Psychosomatic Medicine 76 (1): 58–65.
Chicago author-date (all authors)
Mastenbroek, Mirjam H, Henneke Versteeg, Luc Jordaens, Dominic AMJ Theuns, and Susanne S Pedersen. 2014. “Ventricular Tachyarrhythmias and Mortality in Patients with an Implantable Cardioverter Defibrillator: Impact of Depression in the MIDAS Cohort.” Psychosomatic Medicine 76 (1): 58–65.
Vancouver
1.
Mastenbroek MH, Versteeg H, Jordaens L, Theuns DA, Pedersen SS. Ventricular tachyarrhythmias and mortality in patients with an implantable cardioverter defibrillator: impact of depression in the MIDAS cohort. PSYCHOSOMATIC MEDICINE. 2014;76(1):58–65.
IEEE
[1]
M. H. Mastenbroek, H. Versteeg, L. Jordaens, D. A. Theuns, and S. S. Pedersen, “Ventricular tachyarrhythmias and mortality in patients with an implantable cardioverter defibrillator: impact of depression in the MIDAS cohort,” PSYCHOSOMATIC MEDICINE, vol. 76, no. 1, pp. 58–65, 2014.
@article{8089113,
  abstract     = {Objective: We examined whether depression is independently associated with implantable cardioverter defibrillator (ICD) therapy for ventricular tachyarrhythmias and mortality. 
Methods: A cohort of 430 consecutive patients with a first-time ICD (79% men; mean [standard deviation] age = 57.8 [12.1] years) completed the Hospital Anxiety and Depression Scale 1 day before implantation. During follow-up, the ICD was interrogated at 3-month intervals. Cox proportional hazard regression analyses were used to examine the impact of depression on time to first appropriate ICD therapy and all-cause mortality during a median follow-up period of 3.8 years. 
Results: Of all patients, 108 (25.1%) were depressed. Depression was not associated with time to first appropriate ICD therapy (unadjusted hazard ratio [HR] = 1.07, 95% confidence interval [CI] = 0.73-1.56). However, depression was associated with an increased risk for all-cause mortality (unadjusted HR = 2.18, 95% CI = 1.36-3.49). Depression remained independently associated with all-cause mortality (HR = 1.94, 95% CI = 1.06-3.54, p = .031), after adjusting for demographic and clinical characteristics. Patients who remained depressed during the first 3 months after implantation were at greatest risk for dying (HR = 2.88, 95% CI = 1.29-6.45, p = .010). 
Conclusions: The current study showed that depression at the time of implant is not associated with time to first appropriate ICD therapy but almost doubled the risk for all-cause mortality in patients with an ICD. Patients with persistent depression during the first 3 months after implantation face the greatest risk of dying. Current evidence indicates that multifactorial interventions are likely to be the most successful in terms of reducing distress. Whether this translates into enhanced survival has yet to be determined.},
  author       = {Mastenbroek, Mirjam H and Versteeg, Henneke and Jordaens, Luc and Theuns, Dominic AMJ and Pedersen, Susanne S},
  issn         = {0033-3174},
  journal      = {PSYCHOSOMATIC MEDICINE},
  keywords     = {depression,ventricular tachyarrhythmias,implantable cardioverter defibrillator,mortality,CORONARY-HEART-DISEASE,CARDIAC RESYNCHRONIZATION THERAPY,ACUTE MYOCARDIAL-INFARCTION,REHABILITATION PROGRAM,HOSPITAL ANXIETY,RATE TURBULENCE,1ST YEAR,RISK,FAILURE,ICD},
  language     = {eng},
  number       = {1},
  pages        = {58--65},
  title        = {Ventricular tachyarrhythmias and mortality in patients with an implantable cardioverter defibrillator: impact of depression in the MIDAS cohort},
  url          = {http://dx.doi.org/10.1097/PSY.0000000000000017},
  volume       = {76},
  year         = {2014},
}

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