Somatic/affective depressive symptoms were significantly associated with adverse cardiovascular prognosis (HR 1.19) in patients with heart disease, whereas cognitive/affective symptoms were not.
Meta-Analysis (n=11,128)
Heart disease (coronary heart disease, acute coronary syndrome, myocardial ischemia, congestive heart failure, or myocardial infarction) (n=11,128)
Somatic/affective depressive symptoms vs Cognitive/affective depressive symptoms
Adverse cardiovascular prognosis (cardiovascular mortality, all-cause mortality, or cardiovascular events) — HR 1.19 (1.10-1.29), p=<0.001
Effect estimate: HR 1.19 (95% CI 1.10-1.29)
p-value: p=<0.001
BACKGROUND: Several prospective longitudinal studies have suggested that somatic/affective depressive symptoms, but not cognitive/affective depressive symptoms, are related to prognosis in patients with heart disease, but findings have been inconsistent. The aim of this study was to investigate the association of cognitive/affective and somatic/affective symptoms of depression with cardiovascular prognosis in patients with heart disease using a meta-analytic perspective. METHOD: A systematic search was performed in PubMed, EMBASE and PsycInfo. Thirteen prospective studies on symptom dimensions of depression and cardiovascular prognosis fulfilled the inclusion criteria, providing data on a total of 11,128 subjects. The risk estimates for each dimension of depressive symptoms, demographic and methodological variables were extracted from the included articles. RESULTS: In least-adjusted analyses, both the somatic/affective hazard ratio (HR) 1.30, 95% confidence interval (CI) 1.19-1.41, p < 0.001 and cognitive/affective (HR 1.07, 95% CI 1.00-1.15, p = 0.05) dimensions of depressive symptoms were associated with cardiovascular prognosis. In fully adjusted analyses, somatic/affective symptoms were significantly associated with adverse prognosis (HR 1.19, 95% CI 1.10-1.29, p < 0.001) but cognitive/affective symptoms were not (HR 1.04, 95% CI 0.97-1.12, p = 0.25). An increase of one standard deviation (±1 s.d.) in the scores of the somatic/affective dimension was associated with a 32% increased risk of adverse outcomes (HR 1.32, 95% CI 1.17-1.48, p < 0.001). CONCLUSIONS: Somatic/affective depressive symptoms were more strongly and consistently associated with mortality and cardiovascular events in patients with heart disease compared with cognitive/affective symptoms. Future research should focus on the mechanisms by which somatic/affective depressive symptoms may affect cardiovascular prognosis.
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Ricardo de Miranda Azevedo
University Medical Center Groningen
Annelieke M. Roest
University Medical Center Groningen
Petra W. Hoen
University Medical Center Groningen
Psychological Medicine
University of Groningen
University Medical Center Groningen
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Azevedo et al. (Mon,) conducted a meta-analysis in Heart disease (coronary heart disease, acute coronary syndrome, myocardial ischemia, congestive heart failure, or myocardial infarction) (n=11,128). Somatic/affective depressive symptoms vs. Cognitive/affective depressive symptoms was evaluated on Adverse cardiovascular prognosis (cardiovascular mortality, all-cause mortality, or cardiovascular events) (HR 1.19, 95% CI 1.10-1.29, p=<0.001). Somatic/affective depressive symptoms were significantly associated with adverse cardiovascular prognosis (HR 1.19) in patients with heart disease, whereas cognitive/affective symptoms were not.
synapsesocial.com/papers/6a0baa9ca4798427da6dd185 — DOI: https://doi.org/10.1017/s0033291714000063