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Depressive symptoms and mental stress-induced myocardial ischemia in patients with coronary heart disease.

Publication ,  Journal Article
Boyle, SH; Samad, Z; Becker, RC; Williams, R; Kuhn, C; Ortel, TL; Kuchibhatla, M; Prybol, K; Rogers, J; O'Connor, C; Velazquez, EJ; Jiang, W
Published in: Psychosom Med
2013

OBJECTIVES: The aim of this study was to examine the associations between depressive symptoms and mental stress-induced myocardial ischemia (MSIMI) in patients with coronary heart disease (CHD). METHODS: Adult patients with documented CHD were recruited for baseline mental stress and exercise stress screening testing as a part of the enrollment process of the Responses of Myocardial Ischemia to Escitalopram Treatment trial. Patients were administered the Beck Depression Inventory II and the Center for Epidemiologic Studies Depression Scale. After a 24-48-hour β-blocker withdrawal, participants completed three mental stress tests followed by a treadmill exercise test. Ischemia was defined as a) any development or worsening of any wall motion abnormality and b) reduction of left ventricular ejection fraction at least 8% by transthoracic echocardiography and/or ischemic ST-segment change by electrocardiography during stress testing. MSIMI was considered present when ischemia occurred in at least one mental test. Data were analyzed using logistic regression adjusting for age, sex, and resting left ventricular ejection fraction. RESULTS: One hundred twenty-five (44.2%) of 283 patients were found to have MSIMI, and 93 (32.9%) had ESIMI. Unadjusted analysis showed that Beck Depression Inventory II scores were positively associated with the probability of MSIMI (odds ratio = 0.1.30: 95% confidence interval = 1.06-1.60, p = .013) and number of MSIMI-positive tasks (all p < .005). These associations were still significant after adjustment for covariates (p values <.05). CONCLUSIONS: In patients with CHD, depressive symptoms were associated with a higher probability of MSIMI. These observations may enhance our understanding of the mechanisms contributing to the association of depressive symptoms to future cardiovascular events. Trial Registration Clinicaltrials.gov identifier: NCT00574847.

Duke Scholars

Published In

Psychosom Med

DOI

EISSN

1534-7796

Publication Date

2013

Volume

75

Issue

9

Start / End Page

822 / 831

Location

United States

Related Subject Headings

  • Stress, Psychological
  • Severity of Illness Index
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
  • Hostility
 

Citation

APA
Chicago
ICMJE
MLA
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Boyle, S. H., Samad, Z., Becker, R. C., Williams, R., Kuhn, C., Ortel, T. L., … Jiang, W. (2013). Depressive symptoms and mental stress-induced myocardial ischemia in patients with coronary heart disease. Psychosom Med, 75(9), 822–831. https://doi.org/10.1097/PSY.0b013e3182a893ae
Boyle, Stephen H., Zainab Samad, Richard C. Becker, Redford Williams, Cynthia Kuhn, Thomas L. Ortel, Maragatha Kuchibhatla, et al. “Depressive symptoms and mental stress-induced myocardial ischemia in patients with coronary heart disease.Psychosom Med 75, no. 9 (2013): 822–31. https://doi.org/10.1097/PSY.0b013e3182a893ae.
Boyle SH, Samad Z, Becker RC, Williams R, Kuhn C, Ortel TL, et al. Depressive symptoms and mental stress-induced myocardial ischemia in patients with coronary heart disease. Psychosom Med. 2013;75(9):822–31.
Boyle, Stephen H., et al. “Depressive symptoms and mental stress-induced myocardial ischemia in patients with coronary heart disease.Psychosom Med, vol. 75, no. 9, 2013, pp. 822–31. Pubmed, doi:10.1097/PSY.0b013e3182a893ae.
Boyle SH, Samad Z, Becker RC, Williams R, Kuhn C, Ortel TL, Kuchibhatla M, Prybol K, Rogers J, O’Connor C, Velazquez EJ, Jiang W. Depressive symptoms and mental stress-induced myocardial ischemia in patients with coronary heart disease. Psychosom Med. 2013;75(9):822–831.

Published In

Psychosom Med

DOI

EISSN

1534-7796

Publication Date

2013

Volume

75

Issue

9

Start / End Page

822 / 831

Location

United States

Related Subject Headings

  • Stress, Psychological
  • Severity of Illness Index
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
  • Hostility