Depression and Outcomes in Japanese Outpatients With Cardiovascular Disease - A Prospective Observational Study
Tsuyoshi Suzuki1, Tsuyoshi Shiga, Hisako Omori
1Department of Cardiology, Tokyo Women's Medical University.
Insights
Depression affects 5.6% of Japanese cardiovascular disease patients and significantly increases their risk of adverse cardiovascular outcomes and death. Early detection and management of depression are crucial for improving patient prognosis.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading cause of mortality worldwide.
- Depression is a common comorbidity in patients with CVD.
- The impact of depression on cardiovascular outcomes in Japanese outpatients requires further investigation.
Purpose of the Study:
- To determine the prevalence of depression in Japanese outpatients with CVD using the Patient Health Questionnaire (PHQ-9).
- To assess the effect of depression on adverse cardiovascular outcomes in this population.
Main Methods:
- A prospective observational study involving 1,453 Japanese outpatients with CVD.
- Depression was diagnosed using the PHQ-9 (score ≥10).
- The primary outcome was the composite of all-cause death or cardiovascular events, tracked over an average follow-up of 584 days.
Main Results:
- Depression was diagnosed in 5.6% of the study cohort (81 patients).
- Factors associated with depression included NYHA class III, living alone, and unemployment.
- Patients with depression had a significantly higher incidence of adverse cardiovascular outcomes (P<0.001).
- Depression was an independent predictor of adverse outcomes (HR 4.64, P<0.001).
Conclusions:
- Depression, identified by PHQ-9, is present in 5.6% of Japanese CVD outpatients.
- Depression is a significant independent risk factor for adverse cardiovascular outcomes in this population.
- These findings highlight the importance of screening for and managing depression in CVD patients.
Background:
The aim of this study was to determine the prevalence of depression assessed by the 9-item test from the Patient Health Questionnaire (PHQ-9) and the effect of depression on adverse cardiovascular outcomes in Japanese outpatients with cardiovascular disease (CVD).
Methods And Results:
This prospective observational study enrolled 1,453 outpatients with CVD (mean age 67±13 years; 31.3% female; 32.6% ischemic heart disease). Depression was defined as a PHQ-9 score ≥10. The main composite outcome was the time to death from any cause or a cardiovascular event. 81 patients (5.6%) were diagnosed with depression (PHQ-9 ≥10). NYHA class III, living alone, and unemployment were independently associated with depression. During an average follow-up of 584±80 days, the main outcome occurred in 85 patients (5.8%). There was a higher incidence of the main outcome in patients with depression than in those without depression (P<0.001). Depression was an independent predictor of the primary outcome (hazard ratio 4.64, 95% confidence interval 2.24-9.09, P<0.001).
Conclusions:
Depression assessed by the PHQ-9 was found in 5.6% of Japanese outpatients with CVD and was an important risk factor for adverse outcomes. (UMIN-CTR No. UMIN 000023514) (Circ J 2016; 80: 2482-2488).
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