Timing of depressive symptom onset and in-hospital complications among acute coronary syndrome inpatients.
BACKGROUND
Recent research has reported an association between in-hospital depression and poorer long-term prognosis and a greater risk of in-hospital complications.


OBJECTIVE
The purpose of the current study was to examine the relationship between past and incident depressive symptoms and in-hospital complications in acute coronary syndrome (ACS) inpatients.


METHODS
A group of 906 ACS inpatients from 12 coronary-care units participated in the study. Incident depressive symptoms were assessed through the Beck Depression Inventory, and participants' were asked about past history of prolonged depressed mood. In-hospital complications were noted as present or absent by nurses, and authors conducted logistic-regression analyses.


RESULTS
A subset of 492 patients (58.4%) experienced an in-hospital complication, the most common being ischemia (48.8%) and cardiac arrest (7.2%). After adjusting for prognostic indicators, incident and past-combined-with-incident depressive symptoms were significantly associated with an increased risk of experiencing an in-hospital complication.


CONCLUSIONS
Incident symptoms, in particular, seem to be prognostic. This finding suggests that acute emotions may be triggering cardiac complications, and early identification of emotional symptoms is warranted.
Grewal
Keerat
K
York University, 4700 Keele St., Toronto, ON, Canada.
Stewart
Donna E
DE
Abbey
Susan E
SE
Leung
Yvonne W
YW
Irvine
Jane
J
Grace
Sherry L
SL
D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology / Q000523:psychology; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000523:psychology; D009864:Ontario / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors