Document Detail


Clinical depression and risk of out-of-hospital cardiac arrest.
MedLine Citation:
PMID:  16432088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The association of depression with coronary heart disease-related mortality has been widely recognized. This finding may partly reflect an association between depression and sudden death, in part because the imbalance between sympathetic and parasympathetic tone is altered in depressed subjects. We, thus, investigated whether the presence and severity of clinical depression was associated with a higher risk of sudden cardiac death. METHODS: We used data from a population-based case-control study of risk factors for incident out-of-hospital cardiac arrest (CA) conducted among enrollees of a health maintenance organization in western Washington State. Cases (n = 2228) were aged 40 to 79 years and experienced CA between January 1, 1980, and December 31, 1994. Controls (n = 4164) were a stratified random sample of enrollees defined by calendar year, age, sex, and prior heart disease. Clinical depression was defined as physician diagnosis of depression or use of antidepressant treatment within the year before the event. Referral to mental health clinics or hospitalization for depression defined severe depression. RESULTS: Clinically depressed patients had a higher odds ratio (OR) of CA (1.88; 95% confidence interval [CI], 1.59-2.23), which persisted after adjustment for confounders (OR, 1.43; 95% CI, 1.18-1.73). The association was observed in both sexes, in various age groups, and in subjects with prior physician-diagnosed heart disease (OR, 1.27; 95% CI, 1.01-1.60) and without prior physician-diagnosed heart disease (OR, 1.71; 95% CI, 1.22-2.41) (P = .13 for the interaction). Compared with nondepressed subjects, the risk of CA was increased in less severely depressed subjects (OR, 1.30; 95% CI, 1.04-1.63) and further increased in severely depressed subjects (OR, 1.77; 95% CI, 1.28-2.45) (P<.001 for trend). CONCLUSION: Clinical depression may be associated with a higher risk of CA independently of established coronary heart disease risk factors.
Authors:
J P Empana; X Jouven; R N Lemaitre; N Sotoodehnia; T Rea; T E Raghunathan; G Simon; D S Siscovick
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of internal medicine     Volume:  166     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-24     Completed Date:  2006-02-23     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  195-200     Citation Subset:  AIM; IM    
Affiliation:
Sudden Death Epidemiology Unit, INSERM Avenir-U258, Hôpital Paul Brousse, Villejuif, France. empana@vjf.inserm.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Case-Control Studies
Cohort Studies
Comorbidity
Confidence Intervals
Coronary Disease / diagnosis,  epidemiology*,  psychology
Depressive Disorder / diagnosis,  epidemiology*,  physiopathology
Emergency Medical Services / statistics & numerical data*
Female
Health Maintenance Organizations / statistics & numerical data*
Heart Arrest / diagnosis,  epidemiology*,  psychology
Humans
Incidence
Male
Middle Aged
Odds Ratio
Probability
Reference Values
Risk Assessment*
Sex Distribution
Survival Analysis
Washington / epidemiology
Grant Support
ID/Acronym/Agency:
HL-42456/HL/NHLBI NIH HHS

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