International journal of cardiology
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Evidence supporting a predictive role for depression in the pathgenesis of coronary heart disease (CHD) has mainly come from studies in Western countries. Conflicting data exist regarding the association between antidepressant use and the incidence of CHD. This population-based study tracked the risk of composite coronary events in a cohort with newly diagnosed depression compared to an age- and gender-matched cohort without depression. The association between antidepressant use and risk of coronary events in individuals with depression was also investigated. ⋯ Depression is associated with an increased risk for CHD. No evidence supporting an association between antidepressants and coronary events was found.
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Renal dysfunction has been proposed for the risk factor for stroke and bleeding in atrial fibrillation (AF). The impact of changes in renal dysfunction over time and the relationship to stroke and bleeding risk in these patients remain unknown. We investigated sequential change in renal function (estimated glomerular filtration rate, eGFR) and the risk for clinical events (ischaemic stroke, death and major bleeding) over time in a cohort of 617 AF patients followed up for 2 years. ⋯ In patients with AF, an absolute decrease in eGFR ≥15 ml/min/1.73 m(2) on Cockcroft-Gault and CKD-EPI, and ≥25 ml/min/1.73 m(2) on MDRD, or a relative reduction (≥25%) in eGFR, independently predicted the risk for the endpoints 'stroke or death', 'death' or (at 6 months) ischaemic stroke. Deteriorating renal function increases the risk of death in AF patients.
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Comparative Study
Six-minute walk test distance and resting oxygen saturations but not functional class predict outcome in adult patients with Eisenmenger syndrome.
Eisenmenger syndrome (ES) represents the extreme manifestation of pulmonary arterial hypertension in patients with congenital heart disease, associated with significant exercise intolerance and mortality. Even though of six-minute-walk-test (6MWT) is routinely used in these patients, little is known about its prognostic value in comparison to functional class. ⋯ The 6MWD and resting SO2, but not functional class were predictive of outcome in this contemporary cohort of Eisenmenger patients and should be incorporated in both risk stratification and management algorithms for these patients.