Session number: 1080
Abstract title: Depression And Quality of Life Following Acute Coronary Syndromes
Author(s):
JS Rumsfeld - Denver VA Medical Center
DJ Magid - Colorado Permanente Medical Group
ME Plomondon - Denver VA Medical Center
JA Spertus - University of Missouri, Kansas City
NR Every - VA Puget Sound Health Care System
AE Sales - VA Puget Sound Health Care System
Objectives: Depression has been associated with subsequent mortality and morbidity following Acute Coronary Syndromes (ACS), but little is known about the association between depression and patient-reported health status. We evaluated depression as an independent predictor of patient-reported anginal frequency, anginal stability, physical limitation, and quality of life seven months following ACS.
Methods: Patients were enrolled in the VA Access To Cardiology Study, a cohort study of all patients with AMI or Unstable Angina discharged from 24 VA medical centers between March, 1998 and February, 1999. Data from 1,957 patients who completed a 7-month post-discharge Seattle Angina Questionnaire (SAQ) were analyzed. Multivariate logistic regression was used to evaluate a history of depression as an independent predictor of anginal frequency, anginal stability, physical limitation, and quality of life as measured by the SAQ.
Results: After adjustment for demographic, cardiac, and non-cardiac factors, depression was a significant predictor of higher anginal frequency (Odds Ratio 2.40, 95% Confidence Interval 1.86-3.10; p<0.001), less anginal stability (OR 2.05, CI 1.53-2.75; p<0.001), greater physical limitation (OR 2.89, CI 2.17-3.86; p<0.001), and worse quality of life (OR 2.84, CI 2.16-3.72; p<0.001).
Conclusions: Depression is an important predictor of patient-reported health status seven months following ACS. Depression is associated with more frequent angina, a less stable anginal pattern, greater physical limitation, and worse quality of life.
Impact statement: These findings further support the importance of recognizing and treating depression in the VA population.