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Association of Depressive Symptoms and Micronutrient Deficiency With Cardiac Event-Free Survival in Patients With Heart Failure

Authors
 EUN KYEUNG SONG  ;  DEBRA K. MOSER  ;  SEOK-MIN KANG  ;  TERRY A. LENNIE 
Citation
 JOURNAL OF CARDIAC FAILURE, Vol.21(12) : 945-951, 2015 
Journal Title
JOURNAL OF CARDIAC FAILURE
ISSN
 1071-9164 
Issue Date
2015
MeSH
Adult ; Aged ; Aged, 80 and over ; Comorbidity ; Cross-Sectional Studies ; Depression/diagnosis ; Depression/epidemiology* ; Disease-Free Survival ; Female ; Follow-Up Studies ; Heart Failure/epidemiology* ; Heart Failure/physiopathology ; Heart Failure/psychology* ; Humans ; Kaplan-Meier Estimate ; Male ; Malnutrition/diagnosis ; Malnutrition/epidemiology* ; Micronutrients/deficiency* ; Middle Aged ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Severity of Illness Index ; Surveys and Questionnaires* ; Tertiary Care Centers ; Time Factors
Keywords
Depression ; nutrition ; outcomes
Abstract
BACKGROUND: Depressive symptoms and malnutrition independently predict cardiac events in heart failure (HF) patients. However, the relationships among depressive symptoms, nutritional intake, and cardiac event-free survival have not been examined.

METHODS AND RESULTS: A total of 232 patients with HF completed the Patient Health Questionnaire 9 (PHQ-9) to measure depressive symptoms and a 3-day food diary to determine the number of micronutrient deficiencies. Patients were followed for 2 years to collect data on cardiac event-free survival. Patients were divided into 4 groups by a PHQ-9 score of 10 and the median value of micronutrient deficiencies. Cox regressions were used to determine the relationships among depressive symptoms, micronutrient deficiency, and cardiac event-free survival. Depressive symptoms conferred greater risk of cardiac events in patients with a high number of micronutrient deficiencies than in those with a low number of micronutrient deficiencies. Patients with a PHQ-9 score ≥10 and number of micronutrient deficiencies >5 had 2.4 times higher risk for cardiac events compared with patients with a PHQ-9 score <10 and micronutrient deficiency ≤5 (P = .005).

CONCLUSIONS: There was a synergistic effect on the association of depressive symptoms with cardiac event-free survival in HF patients that differed by micronutrient deficiency.
Full Text
http://www.sciencedirect.com/science/article/pii/S1071916415011318
DOI
10.1016/j.cardfail.2015.10.007
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157217
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