Abstract
BackgroundPsychological distress is common in patients with cardiovascular disease and negatively impacts outcome.HypothesisPsychological distress is high in acute high risk cardiac patients eligible for a WCD, and associated with low quality of life. Distress is aggravated by WCD.MethodsConsecutive patients eligible for a WCD were included in the prospective, multicenter “Cologne Registry of External Defibrillator” registry. Quality of life (Short Form-12), depressive symptoms (Beck-Depression Inventory II) and anxiety (State Trait Anxiety Inventory) were assessed at enrollment and 6-weeks, and associations with WCD prescription were analyzed.Results123 patients (mean [SD] age 59 [± 14] years, 75% male) were included, 85 (69%) of whom received a WCD. At enrollment 21% showed clinically significant depressive symptoms and 52% anxiety symptoms, respectively. At 6 weeks, depressive and anxious symptoms significantly decreased to 7% and 25%, respectively. Depressive symptoms at enrollment and changes at 6 weeks showed significant associations with health-related quality of life, whereas anxious symptoms did not. There was a trend for better improvement of depression scores in patients with WCD (mean [SD] change in score points: -4.1 [6.1] vs -1.8 [3.9]; p = 0.09), whereas change of the anxiousness score was not different (-4.6 [9.5]) vs -3.7 [9.1], p = 0.68).ConclusionIn patients eligible for a WCD, depressive and anxiety symptoms were initially common and depressive symptoms showed a strong association with reduced health-related quality of life contributing to their clinical relevance. WCD recipients showed at least similar improvement of depression and anxiety at 6 weeks when compared to non recipients.
Highlights
Psychological distress is associated with the development and prognosis of cardiovascular disease, and receives increasing attention in clinical care [1, 2]
In patients eligible for a wearable cardioverter defibrillator (WCD), depressive and anxiety symptoms were initially common and depressive symptoms showed a strong association with reduced health-related quality of life contributing to their clinical relevance
WCD recipients showed at least similar improvement of depression and anxiety at 6 weeks when compared to non recipients
Summary
Psychological distress is associated with the development and prognosis of cardiovascular disease, and receives increasing attention in clinical care [1, 2]. About one in five patients with chronic heart failure has symptoms of depression, and presence of depression is associated with increased risk of hospitalization and mortality [3, 4]. Similar findings were reported for anxiety, with a strong mutual correlation between depression and anxiety [5, 6]. Both factors substantially contribute to the severely impaired health related quality of life in patients with chronic heart failure [7]. Psychological distress is high in acute high risk cardiac patients eligible for a WCD, and associated with low quality of life.
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