Document Detail

Accuracy and prognostic value of American Heart Association: recommended depression screening in patients with coronary heart disease: data from the Heart and Soul Study.
MedLine Citation:
PMID:  21862720     Owner:  NLM     Status:  MEDLINE    
BACKGROUND- In 2008, the American Heart Association (AHA) recommended a 2-step screening method, consisting of the 2-item Patient Health Questionnaire (PHQ-2) followed by the 9-item Patient Health Questionnaire (PHQ-9), for identifying depression in cardiovascular patients. The accuracy and prognostic value of this screening method have not been evaluated. METHODS AND RESULTS- We administered the 2-step AHA-recommended screening algorithm to 1024 patients with stable coronary heart disease and calculated sensitivity and specificity against a gold standard interview for major depressive disorder. Subsequent cardiovascular events (myocardial infarction, stroke, transient ischemic attack, heart failure, or death) were determined during a mean of 6.27 ± 2.11 years of follow-up. The AHA-recommended screening method had high specificity (0.91; 95% confidence interval, 0.89 to 0.93) but low sensitivity (0.52; 95% confidence interval, 0.46 to 0.59) for a diagnosis of major depressive disorder. Participants who screened positive on the AHA depression protocol had a 55% greater risk of events than those who screened negative (age-adjusted hazard ratio, 1.55; 95% confidence interval, 1.21 to 1.97; P=0.0005). After adjustment for age, sex, body mass index, history of myocardial infarction, hypertension, diabetes, heart failure, and high-density lipoprotein levels, screening positive remained associated with a 41% greater rate of cardiovascular events (hazard ratio, 1.41; 95% confidence interval, 1.10 to 1.81; P=0.008). CONCLUSIONS- Among outpatients with stable coronary heart disease, the AHA-recommended depression screening protocol is highly specific for depression and identifies patients at risk for adverse cardiovascular outcomes.
Larkin Elderon; Kim G Smolderen; Beeya Na; Mary A Whooley
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2011-08-23
Journal Detail:
Title:  Circulation. Cardiovascular quality and outcomes     Volume:  4     ISSN:  1941-7705     ISO Abbreviation:  Circ Cardiovasc Qual Outcomes     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-21     Completed Date:  2012-01-26     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  101489148     Medline TA:  Circ Cardiovasc Qual Outcomes     Country:  United States    
Other Details:
Languages:  eng     Pagination:  533-40     Citation Subset:  IM    
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MeSH Terms
American Heart Association
Coronary Disease / diagnosis*,  epidemiology*,  mortality,  physiopathology
Depressive Disorder, Major / epidemiology*
Diagnostic Tests, Routine / psychology,  statistics & numerical data
Follow-Up Studies
Middle Aged
Myocardial Infarction
Predictive Value of Tests
Questionnaires* / standards
Sensitivity and Specificity
Survival Analysis
United States
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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