Helle Spindler

TY - JOUR

T1 - Symptomatic heart failure is the most important clinical correlate of impaired quality of life, anxiety, and depression in implantable cardioverter-defibrillator patients: a single-centre, cross-sectional study in 610 patients.

AU - Johansen, Jens Brock

AU - Pedersen, Susanne S

AU - Spindler, Helle

AU - Andersen, Kirsten

AU - Nielsen, Jens C

AU - Mortensen, Peter

PY - 2008

Y1 - 2008

N2 - AIMS: To identify correlates of impaired quality of life (QOL), anxiety, and depression in patients with an implantable cardioverter-defibrillator (ICD). METHODS AND RESULTS: Surviving patients (n = 610) who received an ICD in our institution since 1989 completed the Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale. Mean age was 62.4 years with 18% females. In a multivariate logistic regression analysis, symptomatic heart failure was the most important correlate of impaired QOL (SF-36) across all eight subscales [odds ratios (ORs) ranging from 5.21 to 22.53)], whereas psychotropic medication, age, comorbidity, amiodarone, and ICD shocks all correlated to a lesser extent. Symptomatic heart failure was also the most dominant correlate of anxiety [OR 5.15 (3.08-8.63), P < 0.001] and depression [OR 6.82 (3.77-12.39), P < 0.001]. Implantable cardioverter-defibrillator shocks correlated less yet significantly with anxiety [OR 2.21 (1.32-3.72) P < 0.01] and depression [OR 2.00 (1.06-3.80), P < 0.05]. CONCLUSION: Symptomatic heart failure was the single most important clinical correlate of impaired QOL, anxiety, and depression, with ICD shocks playing only a secondary role. This suggests that comorbidity rather than ICD therapy per se influences patients' device acceptance, supporting the increasing use of prophylactic ICD implantation.

AB - AIMS: To identify correlates of impaired quality of life (QOL), anxiety, and depression in patients with an implantable cardioverter-defibrillator (ICD). METHODS AND RESULTS: Surviving patients (n = 610) who received an ICD in our institution since 1989 completed the Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale. Mean age was 62.4 years with 18% females. In a multivariate logistic regression analysis, symptomatic heart failure was the most important correlate of impaired QOL (SF-36) across all eight subscales [odds ratios (ORs) ranging from 5.21 to 22.53)], whereas psychotropic medication, age, comorbidity, amiodarone, and ICD shocks all correlated to a lesser extent. Symptomatic heart failure was also the most dominant correlate of anxiety [OR 5.15 (3.08-8.63), P < 0.001] and depression [OR 6.82 (3.77-12.39), P < 0.001]. Implantable cardioverter-defibrillator shocks correlated less yet significantly with anxiety [OR 2.21 (1.32-3.72) P < 0.01] and depression [OR 2.00 (1.06-3.80), P < 0.05]. CONCLUSION: Symptomatic heart failure was the single most important clinical correlate of impaired QOL, anxiety, and depression, with ICD shocks playing only a secondary role. This suggests that comorbidity rather than ICD therapy per se influences patients' device acceptance, supporting the increasing use of prophylactic ICD implantation.

KW - Anxiety

KW - Comorbidity

KW - Cross-Sectional Studies

KW - Defibrillators, Implantable

KW - Denmark

KW - Depression

KW - Female

KW - Heart Failure

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Quality of Life

KW - Risk Assessment

KW - Risk Factors

KW - Statistics as Topic

U2 - 10.1093/europace/eun073

DO - 10.1093/europace/eun073

M3 - Journal article

C2 - 18378633

VL - 10

SP - 545

EP - 551

JO - Europace

JF - Europace

SN - 1099-5129

IS - 5

ER -