Poor health status and distress in cardiac patients

The role of device therapy vs. underlying heart disease

M. Habibovic, H. Versteeg, A.J.M. Pelle, D.A.M.J. Theuns, L. Jordaens, S.S. Pedersen

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Aims
Implantable cardioverter defibrillator (ICD) therapy, which includes the risk of shocks, is considered the primary culprit of reductions in patient reported outcomes (PROs; e.g. health status and distress), thereby negating the role of underlying disease severity. We examined the relative influence of living with an ICD vs. congestive heart failure (CHF) on PROs and compared (i) ICD patients without CHF (ICD only), (ii) CHF patients without an ICD (CHF-only), and (iii) CHF patients with an ICD (ICD + CHF).
Methods and results
Separate cohorts of ICD and CHF patients (N = 435; 75% men) completed PROs at baseline, 6 and 12 months. Groups differed on physical health status only at baseline (F(2,415) = 7.15, P = 0.001) and on anxiety at 12 months (F(2,415) = 4.04, P = 0.01); ICD + CHF patients had the most impaired physical health status but the lowest anxiety level followed by the ICD only and CHF only patients. Congestive heart failure only patients had the most impaired mental health status and reported the highest level of anxiety as compared to the ICD only (P < 0.001) and ICD + CHF groups (P = 0.009), while the two latter groups did not differ. The effect sizes ranged from very small (0.03) to moderate-large (0.69). Groups did not differ in depression scores.
Conclusion
Congestive heart failure patients reported worse PROs as compared to ICD patients, although the magnitude of the differences was relatively small. This suggests that the well being of patients is not necessarily negatively influenced by the implantation of an ICD, and that underlying heart disease may have at least an equal if not greater influence on PROs.
Keywords: Anxiety, Congestive heart failure, Depression, Implantable cardioverter defibrillator, Health status
Original languageEnglish
Pages (from-to)355-361
JournalEuropace
Volume15
Issue number3
DOIs
Publication statusPublished - 2013

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Equipment and Supplies
Depression
Implantable Defibrillators
Mental Health

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Habibovic, M., Versteeg, H., Pelle, A. J. M., Theuns, D. A. M. J., Jordaens, L., & Pedersen, S. S. (2013). Poor health status and distress in cardiac patients: The role of device therapy vs. underlying heart disease. Europace, 15(3), 355-361. https://doi.org/10.1093/europace/eus295
Habibovic, M. ; Versteeg, H. ; Pelle, A.J.M. ; Theuns, D.A.M.J. ; Jordaens, L. ; Pedersen, S.S. / Poor health status and distress in cardiac patients : The role of device therapy vs. underlying heart disease. In: Europace. 2013 ; Vol. 15, No. 3. pp. 355-361.
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abstract = "AimsImplantable cardioverter defibrillator (ICD) therapy, which includes the risk of shocks, is considered the primary culprit of reductions in patient reported outcomes (PROs; e.g. health status and distress), thereby negating the role of underlying disease severity. We examined the relative influence of living with an ICD vs. congestive heart failure (CHF) on PROs and compared (i) ICD patients without CHF (ICD only), (ii) CHF patients without an ICD (CHF-only), and (iii) CHF patients with an ICD (ICD + CHF).Methods and resultsSeparate cohorts of ICD and CHF patients (N = 435; 75{\%} men) completed PROs at baseline, 6 and 12 months. Groups differed on physical health status only at baseline (F(2,415) = 7.15, P = 0.001) and on anxiety at 12 months (F(2,415) = 4.04, P = 0.01); ICD + CHF patients had the most impaired physical health status but the lowest anxiety level followed by the ICD only and CHF only patients. Congestive heart failure only patients had the most impaired mental health status and reported the highest level of anxiety as compared to the ICD only (P < 0.001) and ICD + CHF groups (P = 0.009), while the two latter groups did not differ. The effect sizes ranged from very small (0.03) to moderate-large (0.69). Groups did not differ in depression scores.ConclusionCongestive heart failure patients reported worse PROs as compared to ICD patients, although the magnitude of the differences was relatively small. This suggests that the well being of patients is not necessarily negatively influenced by the implantation of an ICD, and that underlying heart disease may have at least an equal if not greater influence on PROs.Keywords: Anxiety, Congestive heart failure, Depression, Implantable cardioverter defibrillator, Health status",
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Poor health status and distress in cardiac patients : The role of device therapy vs. underlying heart disease. / Habibovic, M.; Versteeg, H.; Pelle, A.J.M.; Theuns, D.A.M.J.; Jordaens, L.; Pedersen, S.S.

In: Europace, Vol. 15, No. 3, 2013, p. 355-361.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Poor health status and distress in cardiac patients

T2 - The role of device therapy vs. underlying heart disease

AU - Habibovic, M.

AU - Versteeg, H.

AU - Pelle, A.J.M.

AU - Theuns, D.A.M.J.

AU - Jordaens, L.

AU - Pedersen, S.S.

PY - 2013

Y1 - 2013

N2 - AimsImplantable cardioverter defibrillator (ICD) therapy, which includes the risk of shocks, is considered the primary culprit of reductions in patient reported outcomes (PROs; e.g. health status and distress), thereby negating the role of underlying disease severity. We examined the relative influence of living with an ICD vs. congestive heart failure (CHF) on PROs and compared (i) ICD patients without CHF (ICD only), (ii) CHF patients without an ICD (CHF-only), and (iii) CHF patients with an ICD (ICD + CHF).Methods and resultsSeparate cohorts of ICD and CHF patients (N = 435; 75% men) completed PROs at baseline, 6 and 12 months. Groups differed on physical health status only at baseline (F(2,415) = 7.15, P = 0.001) and on anxiety at 12 months (F(2,415) = 4.04, P = 0.01); ICD + CHF patients had the most impaired physical health status but the lowest anxiety level followed by the ICD only and CHF only patients. Congestive heart failure only patients had the most impaired mental health status and reported the highest level of anxiety as compared to the ICD only (P < 0.001) and ICD + CHF groups (P = 0.009), while the two latter groups did not differ. The effect sizes ranged from very small (0.03) to moderate-large (0.69). Groups did not differ in depression scores.ConclusionCongestive heart failure patients reported worse PROs as compared to ICD patients, although the magnitude of the differences was relatively small. This suggests that the well being of patients is not necessarily negatively influenced by the implantation of an ICD, and that underlying heart disease may have at least an equal if not greater influence on PROs.Keywords: Anxiety, Congestive heart failure, Depression, Implantable cardioverter defibrillator, Health status

AB - AimsImplantable cardioverter defibrillator (ICD) therapy, which includes the risk of shocks, is considered the primary culprit of reductions in patient reported outcomes (PROs; e.g. health status and distress), thereby negating the role of underlying disease severity. We examined the relative influence of living with an ICD vs. congestive heart failure (CHF) on PROs and compared (i) ICD patients without CHF (ICD only), (ii) CHF patients without an ICD (CHF-only), and (iii) CHF patients with an ICD (ICD + CHF).Methods and resultsSeparate cohorts of ICD and CHF patients (N = 435; 75% men) completed PROs at baseline, 6 and 12 months. Groups differed on physical health status only at baseline (F(2,415) = 7.15, P = 0.001) and on anxiety at 12 months (F(2,415) = 4.04, P = 0.01); ICD + CHF patients had the most impaired physical health status but the lowest anxiety level followed by the ICD only and CHF only patients. Congestive heart failure only patients had the most impaired mental health status and reported the highest level of anxiety as compared to the ICD only (P < 0.001) and ICD + CHF groups (P = 0.009), while the two latter groups did not differ. The effect sizes ranged from very small (0.03) to moderate-large (0.69). Groups did not differ in depression scores.ConclusionCongestive heart failure patients reported worse PROs as compared to ICD patients, although the magnitude of the differences was relatively small. This suggests that the well being of patients is not necessarily negatively influenced by the implantation of an ICD, and that underlying heart disease may have at least an equal if not greater influence on PROs.Keywords: Anxiety, Congestive heart failure, Depression, Implantable cardioverter defibrillator, Health status

U2 - 10.1093/europace/eus295

DO - 10.1093/europace/eus295

M3 - Article

VL - 15

SP - 355

EP - 361

JO - Europace

JF - Europace

SN - 1099-5129

IS - 3

ER -