University of Oulu

inna Lahtinen, Antti M. Kiviniemi, M. Juhani Junttila, Maria Kääriäinen, Heikki V. Huikuri, Mikko P. Tulppo, Depressive Symptoms and Risk for Sudden Cardiac Death in Stable Coronary Artery Disease, The American Journal of Cardiology, Volume 122, Issue 5, 2018, Pages 749-755, ISSN 0002-9149,

Depressive symptoms and risk for sudden cardiac death in stable coronary artery disease

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Author: Lahtinen, Minna1,2; Kiviniemi, Antti M.1; Junttila, M. Juhani1;
Organizations: 1Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
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Language: English
Published: Elsevier, 2018
Publish Date: 2019-06-02


The association between the mode of death and depression in patients with stable coronary artery disease (CAD) is far from clear. We investigated the association between depressive symptoms and the mode of death including all-cause mortality, noncardiac death, sudden cardiac death (SCD), and non-SCD in stable CAD patients. Patients with angiographically documented CAD (n = 1,928) underwent a clinical examination including screening for depression symptoms with the Depression Scale (DEPS) and extensive risk profiling at the baseline. The patients were divided into quartiles based on their DEPS score. The patients entered the follow-up (median 6.3 years) during which 49 SCDs (2.5%) and 48 non-SCDs (2.5%) occurred. The incidence of SCD was 1.1% (5 events), 2.0% (9 events), 2.6% (14 events), and 4.4% (21 events) from the lowest to the highest quartile of DEPS. The patients in the highest quartile of DEPS had a fourfold elevated univariate risk (95% confidence interval 1.5 to 10.5; p = 0.006), and after adjustment for traditional risk factors, a 3.2-fold elevated multivariate risk (95% confidence interval 1.2 to 8.9, p = 0.025) for SCD compared with patients in the lowest quartile. DEPS was not associated with non-SCD or noncardiac deaths. Depressive symptoms are associated with an increased risk of SCD independently of clinical risk factors in patients with CAD. The results highlight the importance of screening for depression and emphasize the need for additional interventions to alleviate the depressive symptoms in these patients.

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Series: The American journal of cardiology
ISSN: 0002-9149
ISSN-E: 1879-1913
ISSN-L: 0002-9149
Volume: 122
Issue: 5
Pages: 749 - 755
DOI: 10.1016/j.amjcard.2018.05.006
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3124 Neurology and psychiatry
Funding: Funded by the Finnish Technology Development Center (TEKES) Helsinki, Finland, theAcademy of Finland (#267435), Helsinki, Finland, and the Sigrid Juselius Foundation, Helsinki, Finland.
Academy of Finland Grant Number: 267435
Detailed Information: 267435 (Academy of Finland Funding decision)
Copyright information: © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license