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Relationship between cardiopulmonary fitness and depressive symptoms in cardiac rehabilitation patients with coronary artery disease
OBJECTIVE: To identify independent predictors of depressive symptoms in a cohort of patients with coronary artery disease entering cardiac rehabilitation.
DESIGN: Cross-sectional cohort study.
Patients and methods: Consecutive patients entering a cardiac rehabilitation and secondary prevention programme underwent screening for depressive symptoms using the Center for Epidemiological Studies Depression (CES-D) scale and cardiopulmonary fitness testing to quantify peak oxygen consumption.
RESULTS: Of the 366 patients with coronary artery disease, 22.3% reported at least mild (CES-D ≥ 16) and 10.4% reported significant (CES-D ≥ 23) depressive symptoms. Antidepressant medications were being used by 6.3% of patients. Sociodemographic, cardiopulmonary and cardiac characteristics, and medical co-morbidities previously associated with depression accounted for 14.7% of the variance in a multiple linear regression model (F = 8.713, p < 0.001) predicting CES-D scores. Significant independent predictors of CES-D scores were lower peak oxygen consumption, younger age, female sex, lower maximum diastolic blood pressure, angina pectoris and antidepressant use.
CONCLUSION: Reduced physical fitness, younger age, female sex and ischaemic symptoms of coronary artery disease predict higher depressive symptoms in patients entering cardiac rehabilitation.
Walter Swardfager, Nathan Herrmann, Yekta Dowlati, Paul Oh, Alex Kiss, Krista Lanctôt
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