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@ARTICLE{Peter:168832,
author = {R. S. Peter and A. Jaensch and U. Mons$^*$ and B.
Schöttker$^*$ and R. Schmucker and W. Koenig and H.
Brenner$^*$ and D. Rothenbacher$^*$},
title = {{P}rognostic value of long-term trajectories of depression
for incident diabetes mellitus in patients with stable
coronary heart disease.},
journal = {Cardiovascular diabetology},
volume = {20},
number = {1},
issn = {1475-2840},
address = {London},
publisher = {BioMed Central},
reportid = {DKFZ-2021-01083},
pages = {108},
year = {2021},
note = {#LA:C070# /2021 May 13;20(1):108},
abstract = {Diabetes mellitus (DM) and depression are bidirectionally
interrelated. We recently identified long-term trajectories
of depression symptom severity in individuals with coronary
heart disease (CHD), which were associated with the risk for
subsequent cardiovascular events (CVE). We now investigated
the prognostic value of these trajectories of symptoms of
depression with the risk of incident DM in patients with
stable coronary heart disease.The KAROLA cohort included CHD
patients participating in an in-patient rehabilitation
program (years 1999/2000) and followed for up to 15 years.
We included 1048 patients (mean age 59.4 years, $15\%$
female) with information on prevalent DM at baseline and
follow-up data. Cox proportional hazards models were used to
model the risk for incident DM during follow-up by
depression trajectory class adjusted for age, sex,
education, smoking status, body mass index, and physical
activity. In addition, we modeled the excess risk for
subsequent CVE due to incident DM during follow-up for each
of the depression trajectories.DM was prevalent in $20.7\%$
of patients at baseline. Over follow-up, 296 $(28.2\%)$ of
patients had a subsequent CVE. During follow-up, 157
$(15.0\%)$ patients developed incident DM before
experiencing a subsequent CVE. Patients following a
high-stable depression symptom trajectory were at
substantially higher risk of developing incident DM than
patients following a low-stable depression symptom
trajectory (hazard ratio (HR) = 2.50; $95\%$ confidence
interval (CI) (1.35, 4.65)). A moderate-stable and an
increasing depression trajectory were associated with HRs of
1.48 $(95\%-CI$ (1.10, 1.98)) and 1.77 $(95\%-CI$ (1.00,
3.15)) for incident DM. In addition, patients in the
high-stable depression trajectory class who developed
incident DM during follow-up were at 6.5-fold risk (HR =
6.51; $95\%-CI$ (2.77, 15.3)) of experiencing a subsequent
cardiovascular event.In patients with CHD, following a
trajectory of high stable symptoms of depression was
associated with an increased risk of incident DM.
Furthermore, incident DM in these patients was associated
with a substantially increased risk of subsequent CVE.
Identifying depressive symptoms and pertinent treatment
offers might be an important and promising approach to
enhance outcomes in patients with CHD, which should be
followed up in further research and practice.},
keywords = {Coronary heart disease (Other) / Depression (Other) /
Diabetes mellitus (Other) / Trajectories (Other)},
cin = {M050 / C070},
ddc = {610},
cid = {I:(DE-He78)M050-20160331 / I:(DE-He78)C070-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:33985516},
doi = {10.1186/s12933-021-01298-3},
url = {https://inrepo02.dkfz.de/record/168832},
}