title: Relationship between premature ventricular complexes and depressive symptoms in non-ST-elevation acute coronary syndrome.
abstract: OBJECTIVE
  Depression is a recognized risk marker for mortality among acute coronary syndrome (ACS) patients. We hypothesized that ventricular arrhythmia detected by inpatient telemetry monitoring is more frequent among ACS patients with elevated depressive symptoms compared to those without depressive symptoms.
  
  
  RESULTS
  We analysed data from patients enrolled in a prospective observational study of depression in ACS. Telemetry recordings during the index admission (average recording 21.3±3.0 hours) were analysed for frequent premature ventricular complexes (PVCs), defined as ≥10 per hour. The self-report Beck Depression Inventory (BDI) was used to assess depressive symptoms. Among 200 ACS patients, frequent PVCs were observed in 29% of patients with moderate depressive symptoms (BDI ≥10), 27% of those with mild symptoms (BDI 5-9), and only 11% of those with no/minimal symptoms (p=0.02). Log-transformed PVCs per hour were associated with depressive symptom category (p=0.008). In a multivariable logistic regression model that included age, gender, left ventricular ejection fraction, cardiovascular risk score, heart rate, and QT interval, mild symptoms (OR 3.02, 95% 0.97-9.43, p=0.058) and moderate-severe symptoms (OR 3.94, 95% CI 1.27-12.22, p=0.018) were associated with frequent PVCs.
  
  
  CONCLUSIONS
  In this sample of ACS patients, depressive symptoms were independently associated with frequent PVCs during inpatient telemetry monitoring.
authors.affiliation: Columbia University, New York, NY, USA.
authors.forename: William
authors.initials: W
authors.lastname: Whang
authors.forename: James
authors.initials: J
authors.lastname: Peacock
authors.forename: Ana V
authors.initials: AV
authors.lastname: Soto
authors.forename: Tomas
authors.initials: T
authors.lastname: Borda
authors.forename: Anupama B
authors.initials: AB
authors.lastname: Bhatt
authors.forename: Safiya I
authors.initials: SI
authors.lastname: Richardson
authors.forename: Matthew
authors.initials: M
authors.lastname: Burg
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
mesh_terms: D006801:Humans; D011446:Prospective Studies; D054058:Acute Coronary Syndrome / Q000150:complications; D003863:Depression / Q000209:etiology; D018879:Ventricular Premature Complexes / Q000150:complications; D012307:Risk Factors; D016277:Ventricular Function, Left; D016015:Logistic Models
keywords: Acute coronary syndrome; arrhythmia; depression
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