Depressive symptomatology in relation to 10-year (2004-2014) Acute Coronary Syndrome incidence; the moderating role of diet and financial status.

Auteur(s) :
Panagiotakos DB., Pitsavos C., Notara V., Tsompanaki E., Kouvari M., Kogias Y., Papanagnou G., Antonoulas A., Stravopodis P., Zombolos S., Stergiouli I., Mantas Y., Babatsikou F.
Date :
Jan, 2016
Source(s) :
Preventive medicine. # p
Adresse :
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.

Sommaire de l'article
Imprimer

BACKGROUND
The association between depression status and 10-year cardiovascular disease (CVD) incidence among Acute Coronary Syndrome(ACS) patients, in relation to nutritional and financial status, was evaluated.

METHODS
From October 2003-September 2004, a sample of 2,172 consecutive ACS patients from 6 Greek hospitals was enrolled. In 2013-14, the 10-year follow-up was performed. Depressive symptoms were evaluated using the validated CES-D score (range 0-60). Adherence to Mediterranean diet was assessed through MedDietScore (range 0-55) and financial status was determined by the annual income.

RESULTS
Ranking from the 1st to 3rd CES-D tertile, recurrent fatal/non fatal ACS rates were 33%, 37% and 42%, respectively (p=0.006). Multiple logistic regression models revealed an adverse association of severe depression status (i.e. 3rdtertile) compared to no depression (i.e., 1sttertile) [Odds Ratio (OR)=1.31, 95% Confidence Interval (95%CI) 1.01, 1.69]. When controlling for financial status, the relationship between depression and ACS prognosis remained marginally significant; while subgroup analysis revealed that only patients with low/moderate income were negatively affected [OR=1.36, 95%CI 0.98, 1.88]. Further stratified analysis, by MedDietScore group, was applied; the above association remained significant only in patients with low compliance to this dietary pattern [OR=1.68, 95% CI 1.10, 2.18].

CONCLUSIONS
ACS coexisting with severe depression status seems to result in adverse disease outcomes while financial status and Mediterranean diet are proposed as potential moderators. Public health programs should focus on vulnerable groups and minimize depressive symptoms through appropriate medical treatment and lifestyle interventions, so as to ameliorate the disease prognosis in clinical and community level.

Source : Pubmed
Retour