Fatigue, depressive symptoms, and hopelessness as predictors of adverse clinical events following percutaneous coronary intervention with paclitaxel-eluting stents

Susanne S. Pedersen*, Johan Denollet, Joost Daemen, Meike van de Sande, Peter T. de Jaegere, Patrick W. Serruys, Ruud A.M. Erdman, Ron T. van Domburg

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Objective: We investigated the relative effects of fatigue, depressive symptoms, and hopelessness on prognosis at 2-year follow-up in percutaneous coronary intervention (PCI) patients. Methods: Consecutively admitted PCI patients (n=534) treated with paclitaxel-eluting stent as the default strategy completed the Maastricht Questionnaire (MQ) at baseline. Apart from an overall vital exhaustion score, the MQ also assesses fatigue (seven items; Cronbach's α=.87) and depressive symptoms (seven items; Cronbach's α=.83), with hopelessness (one item) comprised in the depressive symptom items. Patients were followed up for adverse clinical events (mortality and nonfatal myocardial infarction) at 2 years. Results: At 2-year follow-up, there were 31 clinical events. In univariable analyses, overall vital exhaustion and depressive symptoms, but not fatigue, were associated with adverse prognosis; in multivariable analysis, depressive symptoms [hazard ratio (HR)=2.69; 95% confidence interval (95% CI)=1.31-5.55] remained the only predictor of clinical outcome. Among the depressive symptoms, hopelessness (HR=3.44; 95% CI=1.65-7.19) was the most cardiotoxic symptom. The incidence of clinical events was higher in the high-hopelessness patients (11% vs. 3%; P=.001) than in the low-hopelessness patients. Hopelessness (HR=3.36; 95% CI=1.58-7.14; P=.002) remained an independent predictor of clinical outcome at 2 years in adjusted analysis. Conclusion: Symptoms of depression, but not fatigue, predicted adverse clinical events. Hopelessness was the most cardiotoxic symptom, associated with a more than three-fold risk of clinical events 2 years post-PCI. Screening for hopelessness may lead to the identification of high-risk patients.

OriginalsprogEngelsk
TidsskriftJournal of Psychosomatic Research
Vol/bind62
Udgave nummer4
Sider (fra-til)455-461
Antal sider7
ISSN0022-3999
DOI
StatusUdgivet - 1. apr. 2007

Fingeraftryk

Stents
Depression
Confidence Intervals
Incidence

Citer dette

Pedersen, Susanne S. ; Denollet, Johan ; Daemen, Joost ; van de Sande, Meike ; de Jaegere, Peter T. ; Serruys, Patrick W. ; Erdman, Ruud A.M. ; van Domburg, Ron T. / Fatigue, depressive symptoms, and hopelessness as predictors of adverse clinical events following percutaneous coronary intervention with paclitaxel-eluting stents. I: Journal of Psychosomatic Research. 2007 ; Bind 62, Nr. 4. s. 455-461.
@article{b883d0289a334a91a809a93cca2e5c2c,
title = "Fatigue, depressive symptoms, and hopelessness as predictors of adverse clinical events following percutaneous coronary intervention with paclitaxel-eluting stents",
abstract = "Objective: We investigated the relative effects of fatigue, depressive symptoms, and hopelessness on prognosis at 2-year follow-up in percutaneous coronary intervention (PCI) patients. Methods: Consecutively admitted PCI patients (n=534) treated with paclitaxel-eluting stent as the default strategy completed the Maastricht Questionnaire (MQ) at baseline. Apart from an overall vital exhaustion score, the MQ also assesses fatigue (seven items; Cronbach's α=.87) and depressive symptoms (seven items; Cronbach's α=.83), with hopelessness (one item) comprised in the depressive symptom items. Patients were followed up for adverse clinical events (mortality and nonfatal myocardial infarction) at 2 years. Results: At 2-year follow-up, there were 31 clinical events. In univariable analyses, overall vital exhaustion and depressive symptoms, but not fatigue, were associated with adverse prognosis; in multivariable analysis, depressive symptoms [hazard ratio (HR)=2.69; 95{\%} confidence interval (95{\%} CI)=1.31-5.55] remained the only predictor of clinical outcome. Among the depressive symptoms, hopelessness (HR=3.44; 95{\%} CI=1.65-7.19) was the most cardiotoxic symptom. The incidence of clinical events was higher in the high-hopelessness patients (11{\%} vs. 3{\%}; P=.001) than in the low-hopelessness patients. Hopelessness (HR=3.36; 95{\%} CI=1.58-7.14; P=.002) remained an independent predictor of clinical outcome at 2 years in adjusted analysis. Conclusion: Symptoms of depression, but not fatigue, predicted adverse clinical events. Hopelessness was the most cardiotoxic symptom, associated with a more than three-fold risk of clinical events 2 years post-PCI. Screening for hopelessness may lead to the identification of high-risk patients.",
keywords = "Coronary artery disease, Depressive symptoms, Fatigue, Hopelessness, Percutaneous coronary intervention, Prognosis",
author = "Pedersen, {Susanne S.} and Johan Denollet and Joost Daemen and {van de Sande}, Meike and {de Jaegere}, {Peter T.} and Serruys, {Patrick W.} and Erdman, {Ruud A.M.} and {van Domburg}, {Ron T.}",
year = "2007",
month = "4",
day = "1",
doi = "10.1016/j.jpsychores.2006.12.018",
language = "English",
volume = "62",
pages = "455--461",
journal = "Journal of Psychosomatic Research",
issn = "0022-3999",
publisher = "Heinemann",
number = "4",

}

Fatigue, depressive symptoms, and hopelessness as predictors of adverse clinical events following percutaneous coronary intervention with paclitaxel-eluting stents. / Pedersen, Susanne S.; Denollet, Johan; Daemen, Joost; van de Sande, Meike; de Jaegere, Peter T.; Serruys, Patrick W.; Erdman, Ruud A.M.; van Domburg, Ron T.

I: Journal of Psychosomatic Research, Bind 62, Nr. 4, 01.04.2007, s. 455-461.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Fatigue, depressive symptoms, and hopelessness as predictors of adverse clinical events following percutaneous coronary intervention with paclitaxel-eluting stents

AU - Pedersen, Susanne S.

AU - Denollet, Johan

AU - Daemen, Joost

AU - van de Sande, Meike

AU - de Jaegere, Peter T.

AU - Serruys, Patrick W.

AU - Erdman, Ruud A.M.

AU - van Domburg, Ron T.

PY - 2007/4/1

Y1 - 2007/4/1

N2 - Objective: We investigated the relative effects of fatigue, depressive symptoms, and hopelessness on prognosis at 2-year follow-up in percutaneous coronary intervention (PCI) patients. Methods: Consecutively admitted PCI patients (n=534) treated with paclitaxel-eluting stent as the default strategy completed the Maastricht Questionnaire (MQ) at baseline. Apart from an overall vital exhaustion score, the MQ also assesses fatigue (seven items; Cronbach's α=.87) and depressive symptoms (seven items; Cronbach's α=.83), with hopelessness (one item) comprised in the depressive symptom items. Patients were followed up for adverse clinical events (mortality and nonfatal myocardial infarction) at 2 years. Results: At 2-year follow-up, there were 31 clinical events. In univariable analyses, overall vital exhaustion and depressive symptoms, but not fatigue, were associated with adverse prognosis; in multivariable analysis, depressive symptoms [hazard ratio (HR)=2.69; 95% confidence interval (95% CI)=1.31-5.55] remained the only predictor of clinical outcome. Among the depressive symptoms, hopelessness (HR=3.44; 95% CI=1.65-7.19) was the most cardiotoxic symptom. The incidence of clinical events was higher in the high-hopelessness patients (11% vs. 3%; P=.001) than in the low-hopelessness patients. Hopelessness (HR=3.36; 95% CI=1.58-7.14; P=.002) remained an independent predictor of clinical outcome at 2 years in adjusted analysis. Conclusion: Symptoms of depression, but not fatigue, predicted adverse clinical events. Hopelessness was the most cardiotoxic symptom, associated with a more than three-fold risk of clinical events 2 years post-PCI. Screening for hopelessness may lead to the identification of high-risk patients.

AB - Objective: We investigated the relative effects of fatigue, depressive symptoms, and hopelessness on prognosis at 2-year follow-up in percutaneous coronary intervention (PCI) patients. Methods: Consecutively admitted PCI patients (n=534) treated with paclitaxel-eluting stent as the default strategy completed the Maastricht Questionnaire (MQ) at baseline. Apart from an overall vital exhaustion score, the MQ also assesses fatigue (seven items; Cronbach's α=.87) and depressive symptoms (seven items; Cronbach's α=.83), with hopelessness (one item) comprised in the depressive symptom items. Patients were followed up for adverse clinical events (mortality and nonfatal myocardial infarction) at 2 years. Results: At 2-year follow-up, there were 31 clinical events. In univariable analyses, overall vital exhaustion and depressive symptoms, but not fatigue, were associated with adverse prognosis; in multivariable analysis, depressive symptoms [hazard ratio (HR)=2.69; 95% confidence interval (95% CI)=1.31-5.55] remained the only predictor of clinical outcome. Among the depressive symptoms, hopelessness (HR=3.44; 95% CI=1.65-7.19) was the most cardiotoxic symptom. The incidence of clinical events was higher in the high-hopelessness patients (11% vs. 3%; P=.001) than in the low-hopelessness patients. Hopelessness (HR=3.36; 95% CI=1.58-7.14; P=.002) remained an independent predictor of clinical outcome at 2 years in adjusted analysis. Conclusion: Symptoms of depression, but not fatigue, predicted adverse clinical events. Hopelessness was the most cardiotoxic symptom, associated with a more than three-fold risk of clinical events 2 years post-PCI. Screening for hopelessness may lead to the identification of high-risk patients.

KW - Coronary artery disease

KW - Depressive symptoms

KW - Fatigue

KW - Hopelessness

KW - Percutaneous coronary intervention

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=33947331248&partnerID=8YFLogxK

U2 - 10.1016/j.jpsychores.2006.12.018

DO - 10.1016/j.jpsychores.2006.12.018

M3 - Journal article

VL - 62

SP - 455

EP - 461

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

SN - 0022-3999

IS - 4

ER -