Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2016; 8(9): 547-552
Published online Sep 26, 2016. doi: 10.4330/wjc.v8.i9.547
Depression risk in patients with coronary heart disease in Germany
Marcel Konrad, Louis Jacob, Michael A Rapp, Karel Kostev
Marcel Konrad, Department of Health, Fresenius University, 65510 Idstein, Germany
Louis Jacob, Department of Biology, École Normale Supérieure, 69007 Lyon, France
Michael A Rapp, Department of Social and Preventive Medicine, University of Potsdam, 14469 Potsdam, Germany
Karel Kostev, Department of Epidemiology, IMS Health, 60598 Frankfurt am Main, Germany
Author contributions: Konrad M designed and performed the research and wrote the paper; Jacob L designed the research; Rapp MA designed the research and provided clinical advice; Kostev K performed the analysis and supervised the report.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the IMS Health.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous data.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: Technical details and statistical methods are available with the corresponding author at kkostev@de.imshealth.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Karel Kostev, DMSc, PhD, Professor, Department of Epidemiology, IMS Health, Frankfurt am Main, Darmstädter Landstr, 60598 Frankfurt am Main, Germany. kkostev@de.imshealth.com
Telephone: +49-69-66044878 Fax: +49-69-66045878
Received: May 5, 2016
Peer-review started: May 9, 2016
First decision: June 13, 2016
Revised: July 12, 2016
Accepted: July 29, 2016
Article in press: August 1, 2016
Published online: September 26, 2016
Processing time: 137 Days and 5 Hours
Abstract
AIM

To determine the prevalence of depression and its risk factors among patients with coronary heart disease (CHD) treated in German primary care practices.

METHODS

Longitudinal data from nationwide general practices in Germany (n = 1072) were analyzed. Individuals initially diagnosed with CHD (2009-2013) were identified, and 59992 patients were included and matched (1:1) to 59992 controls. The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD. Cox proportional hazards models were used to adjust for confounders.

RESULTS

Mean age was equal to 68.0 years (SD = 11.3). A total of 55.9% of patients were men. After a five-year follow-up, 21.8% of the CHD group and 14.2% of the control group were diagnosed with depression (P < 0.001). In the multivariate regression model, CHD was a strong risk factor for developing depression (HR = 1.54, 95%CI: 1.49-1.59, P < 0.001). Prior depressive episodes, dementia, and eight other chronic conditions were associated with a higher risk of developing depression. Interestingly, older patients and women were also more likely to be diagnosed with depression compared with younger patients and men, respectively.

CONCLUSION

The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany. CHD patients should be routinely screened for depression to ensure improved treatment and management.

Keywords: Coronary heart disease; Depression; Primary care; Risk factors; Quality of life

Core tip: This is a retrospective study to determine the prevalence of depression and its risk factors among patients with coronary heart disease (CHD) treated in German primary care practices. Fifty-nine thousand nine hundred and ninety-two patients with CHD from German primary care practices were included and matched to 59992 controls. After a five-year follow-up, 21.8% of the CHD group and 14.2% of the control group were diagnosed with depression. In the multivariate regression model, CHD was a strong risk factor for developing depression.