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Poor health status and distress in cardiac patients: the role of device therapy vs. underlying heart disease

(2013) EUROPACE. 15(3). p.355-361
Author
Organization
Abstract
Aims: Implantable cardioverter defibrillator (ICD) therapy, which includes the risk of shocks, is considered the primary culprit of reductions in patient reported outcomes (PROs; e.g. health status and distress), thereby negating the role of underlying disease severity. We examined the relative influence of living with an ICD vs. congestive heart failure (CHF) on PROs and compared (i) ICD patients without CHF (ICD only), (ii) CHF patients without an ICD (CHF-only), and (iii) CHF patients with an ICD (ICD + CHF). Methods and results: Separate cohorts of ICD and CHF patients (N = 435; 75% men) completed PROs at baseline, 6 and 12 months. Groups differed on physical health status only at baseline (F-(2,F-415) = 7.15, P = 0.001) and on anxiety at 12 months (F-(2,F-415) = 4.04, P = 0.01); ICD CHF patients had the most impaired physical health status but the lowest anxiety level followed by the ICD only and CHF only patients. Congestive heart failure only patients had the most impaired mental health status and reported the highest level of anxiety as compared to the ICD only (P < 0.001) and ICD + CHF groups (P = 0.009), while the two latter groups did not differ. The effect sizes ranged from very small (0.03) to moderate-large (0.69). Groups did not differ in depression scores. Conclusion: Congestive heart failure patients reported worse PROs as compared to ICD patients, although the magnitude of the differences was relatively small. This suggests that the well being of patients is not necessarily negatively influenced by the implantation of an ICD, and that underlying heart disease may have at least an equal if not greater influence on PROs.
Keywords
Congestive heart failure, Depression, Anxiety, Implantable cardioverter defibrillator, Health status, QUALITY-OF-LIFE, IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS, DEPRESSION SCALE, HOSPITAL ANXIETY, VENTRICULAR-ARRHYTHMIAS, FAILURE, INTERVENTION, VALIDATION, PREVALENCE, INFARCTION

Citation

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MLA
Habibovic, Mirela et al. “Poor Health Status and Distress in Cardiac Patients: The Role of Device Therapy Vs. Underlying Heart Disease.” EUROPACE 15.3 (2013): 355–361. Print.
APA
Habibovic, M., Versteeg, H., Pelle, A. J., Theuns, D. A., Jordaens, L., & Pedersen, S. S. (2013). Poor health status and distress in cardiac patients: the role of device therapy vs. underlying heart disease. EUROPACE, 15(3), 355–361.
Chicago author-date
Habibovic, Mirela, Henneke Versteeg, Aline JM Pelle, Dominic AMJ Theuns, Luc Jordaens, and Susanne S Pedersen. 2013. “Poor Health Status and Distress in Cardiac Patients: The Role of Device Therapy Vs. Underlying Heart Disease.” Europace 15 (3): 355–361.
Chicago author-date (all authors)
Habibovic, Mirela, Henneke Versteeg, Aline JM Pelle, Dominic AMJ Theuns, Luc Jordaens, and Susanne S Pedersen. 2013. “Poor Health Status and Distress in Cardiac Patients: The Role of Device Therapy Vs. Underlying Heart Disease.” Europace 15 (3): 355–361.
Vancouver
1.
Habibovic M, Versteeg H, Pelle AJ, Theuns DA, Jordaens L, Pedersen SS. Poor health status and distress in cardiac patients: the role of device therapy vs. underlying heart disease. EUROPACE. 2013;15(3):355–61.
IEEE
[1]
M. Habibovic, H. Versteeg, A. J. Pelle, D. A. Theuns, L. Jordaens, and S. S. Pedersen, “Poor health status and distress in cardiac patients: the role of device therapy vs. underlying heart disease,” EUROPACE, vol. 15, no. 3, pp. 355–361, 2013.
@article{8101537,
  abstract     = {Aims: Implantable cardioverter defibrillator (ICD) therapy, which includes the risk of shocks, is considered the primary culprit of reductions in patient reported outcomes (PROs; e.g. health status and distress), thereby negating the role of underlying disease severity. We examined the relative influence of living with an ICD vs. congestive heart failure (CHF) on PROs and compared (i) ICD patients without CHF (ICD only), (ii) CHF patients without an ICD (CHF-only), and (iii) CHF patients with an ICD (ICD + CHF). 
Methods and results: Separate cohorts of ICD and CHF patients (N = 435; 75% men) completed PROs at baseline, 6 and 12 months. Groups differed on physical health status only at baseline (F-(2,F-415) = 7.15, P = 0.001) and on anxiety at 12 months (F-(2,F-415) = 4.04, P = 0.01); ICD CHF patients had the most impaired physical health status but the lowest anxiety level followed by the ICD only and CHF only patients. Congestive heart failure only patients had the most impaired mental health status and reported the highest level of anxiety as compared to the ICD only (P < 0.001) and ICD + CHF groups (P = 0.009), while the two latter groups did not differ. The effect sizes ranged from very small (0.03) to moderate-large (0.69). Groups did not differ in depression scores. 
Conclusion: Congestive heart failure patients reported worse PROs as compared to ICD patients, although the magnitude of the differences was relatively small. This suggests that the well being of patients is not necessarily negatively influenced by the implantation of an ICD, and that underlying heart disease may have at least an equal if not greater influence on PROs.},
  author       = {Habibovic, Mirela and Versteeg, Henneke and Pelle, Aline JM and Theuns, Dominic AMJ and Jordaens, Luc and Pedersen, Susanne S},
  issn         = {1099-5129},
  journal      = {EUROPACE},
  keywords     = {Congestive heart failure,Depression,Anxiety,Implantable cardioverter defibrillator,Health status,QUALITY-OF-LIFE,IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS,DEPRESSION SCALE,HOSPITAL ANXIETY,VENTRICULAR-ARRHYTHMIAS,FAILURE,INTERVENTION,VALIDATION,PREVALENCE,INFARCTION},
  language     = {eng},
  number       = {3},
  pages        = {355--361},
  title        = {Poor health status and distress in cardiac patients: the role of device therapy vs. underlying heart disease},
  url          = {http://dx.doi.org/10.1093/europace/eus295},
  volume       = {15},
  year         = {2013},
}

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