Mood Problems Increase the Risk of Mortality in Patients With Lacunar Infarcts: the SMART-MR Study
Psychosomatic Medicine, 04/06/2012Grool AM et al.
Patients with lacunar infarcts may be especially vulnerable for the effect of mood problems on mortality.
Mood problems were assessed with the mental component summary of the 36-item Short-Form Medical Outcomes Study in 1110 patients with symptomatic atherosclerotic disease (mean age 59 years).
Volumetric WML estimates were obtained with 1.5-T magnetic resonance imaging; lacunar infarcts were scored visually.
Cox regression models were adjusted for age, sex, vascular risk, physical functioning, antidepressants and infarcts.
The authors adjusted for CSVD to examine whether it may be an intermediate or confounding factor.
Second, the authors added interaction terms to investigate whether associations differed between patients with CSVD (absent/present).
Patients in the lowest quartile of mental functioning, representing most severe mood problems, were at higher, although not significant, risk of death (hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 0.94–2.30) compared with patients in higher quartiles.
Adjustment for CSVD did not change this association.
Lacunar infarcts, not WML, modified the association of mood problems with mortality (p value for interaction = .01); mood problems strongly increased the risk of mortality in patients with lacunar infarcts (HR = 2.75, 95% CI = 1.41–5.38) but not in those without it (HR = 0.78, 95% CI = 0.39–1.57).
MDLinx connects healthcare professionals and patients to tomorrow's important medical news, while providing the pharmaceutical and healthcare industries with highly targeted interactive marketing, education, content, and medical research solutions.