TY - GEN A1 - Tschorn, Mira A1 - Kuhlmann, Stella Linnea A1 - Rieckmann, Nina A1 - Beer, Katja A1 - Grosse, Laura A1 - Arolt, Volker A1 - Waltenberger, Johannes A1 - Haverkamp, Wilhelm A1 - Müller-Nordhorn, Jacqueline A1 - Hellweg, Rainer A1 - Ströhle, Andreas T1 - Brain-derived neurotrophic factor, depressive symptoms and somatic comorbidity in patients with coronary heart disease T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Objective: Depression and coronary heart disease (CHD) are highly comorbid conditions. Brain-derived neurotrophic factor (BDNF) plays an important role in cardiovascular processes. Depressed patients typically show decreased BDNF concentrations. We analysed the relationship between BDNF and depression in a sample of patients with CHD and additionally distinguished between cognitive-affective and somatic depression symptoms. We also investigated whether BDNF was associated with somatic comorbidity burden, acute coronary syndrome (ACS) or congestive heart failure (CHF). Methods: The following variables were assessed for 225 hospitalised patients with CHD: BDNF concentrations, depression [Patient Health Questionnaire-9 (PHQ-9)], somatic comorbidity (Charlson Comorbidity Index), CHF, ACS, platelet count, smoking status and antidepressant treatment. Results: Regression models revealed that BDNF was not associated with severity of depression. Although depressed patients (PHQ-9 score >7) had significantly lower BDNF concentrations compared to non-depressed patients (p = 0.04), this was not statistically significant after controlling for confounders (p = 0.15). Cognitive-affective symptoms and somatic comorbidity burden each closely missed a statistically significant association with BDNF concentrations (p = 0.08, p = 0.06, respectively). BDNF was reduced in patients with CHF (p = 0.02). There was no covariate-adjusted, significant association between BDNF and ACS. Conclusion: Serum BDNF concentrations are associated with cardiovascular dysfunction. Somatic comorbidities should be considered when investigating the relationship between depression and BDNF. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 850 KW - depression KW - BDNF KW - coronary heart disease KW - heart failure KW - somatic comorbidity KW - acute coronary syndrome Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-557315 SN - 1866-8364 IS - 1 ER - TY - JOUR A1 - Tschorn, Mira A1 - Kuhlmann, Stella Linnea A1 - Rieckmann, Nina A1 - Beer, Katja A1 - Grosse, Laura A1 - Arolt, Volker A1 - Waltenberger, Johannes A1 - Haverkamp, Wilhelm A1 - Müller-Nordhorn, Jacqueline A1 - Hellweg, Rainer A1 - Ströhle, Andreas T1 - Brain-derived neurotrophic factor, depressive symptoms and somatic comorbidity in patients with coronary heart disease JF - Acta Neuropsychiatrica N2 - Objective: Depression and coronary heart disease (CHD) are highly comorbid conditions. Brain-derived neurotrophic factor (BDNF) plays an important role in cardiovascular processes. Depressed patients typically show decreased BDNF concentrations. We analysed the relationship between BDNF and depression in a sample of patients with CHD and additionally distinguished between cognitive-affective and somatic depression symptoms. We also investigated whether BDNF was associated with somatic comorbidity burden, acute coronary syndrome (ACS) or congestive heart failure (CHF). Methods: The following variables were assessed for 225 hospitalised patients with CHD: BDNF concentrations, depression [Patient Health Questionnaire-9 (PHQ-9)], somatic comorbidity (Charlson Comorbidity Index), CHF, ACS, platelet count, smoking status and antidepressant treatment. Results: Regression models revealed that BDNF was not associated with severity of depression. Although depressed patients (PHQ-9 score >7) had significantly lower BDNF concentrations compared to non-depressed patients (p = 0.04), this was not statistically significant after controlling for confounders (p = 0.15). Cognitive-affective symptoms and somatic comorbidity burden each closely missed a statistically significant association with BDNF concentrations (p = 0.08, p = 0.06, respectively). BDNF was reduced in patients with CHF (p = 0.02). There was no covariate-adjusted, significant association between BDNF and ACS. Conclusion: Serum BDNF concentrations are associated with cardiovascular dysfunction. Somatic comorbidities should be considered when investigating the relationship between depression and BDNF. KW - depression KW - BDNF KW - coronary heart disease KW - heart failure KW - somatic comorbidity KW - acute coronary syndrome Y1 - 2020 U6 - https://doi.org/10.1017/neu.2020.31 SN - 1601-5215 SN - 0924-2708 VL - 33 IS - 1 SP - 22 EP - 30 PB - Cambridge Univ. Press CY - Cambridge ER - TY - JOUR A1 - Reibis, Rona Katharina A1 - Salzwedel, Annett A1 - Abreu, Ana A1 - Corra, Ugo A1 - Davos, Constantinos A1 - Döhner, Wolfram A1 - Doherty, Patrick A1 - Frederix, Ines A1 - Hansen, Dominique A1 - Iliou, Marie Christine A1 - Vigorito, Carlo A1 - Völler, Heinz T1 - The importance of return to work BT - How to achieve optimal reintegration in ACS patients JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - The vocational reintegration of patients after an acute coronary syndrome is a crucial step towards complete convalescence from the social as well as the individual point of view. Return to work rates are determined by medical parameters such as left ventricular function, residual ischaemia and heart rhythm stability, as well as by occupational requirement profile such as blue or white collar work, night shifts and the ability to commute (which is, in part, determined by physical fitness). Psychosocial factors including depression, self-perceived health situation and pre-existing cognitive impairment determine the reintegration rate to a significant extent. Patients at risk of poor vocational outcomes should be identified in the early period of rehabilitation to avoid a reintegration failure and to prevent socio-professional exclusion with adverse psychological and financial consequences. A comprehensive healthcare pathway of acute coronary syndrome patients is initiated by cardiac rehabilitation, which includes specific algorithms and assessment tools for risk stratification and occupational restitution. As the first in its kind, this review addresses determinants and legal aspects of reintegration of patients experiencing an acute coronary syndrome, and offers practical advice on reintegration strategies particularly for vulnerable patients. It presents different approaches and scientific findings in the European countries and serves as a recommendation for action. KW - Return to work KW - acute coronary syndrome KW - predictors KW - pension insurance Y1 - 2019 U6 - https://doi.org/10.1177/2047487319839263 SN - 2047-4873 SN - 2047-4881 VL - 26 IS - 13 SP - 1358 EP - 1369 PB - Sage Publ. CY - London ER - TY - GEN A1 - Rauch, Bernhard A1 - Davos, Constantinos H. A1 - Doherty, Patrick A1 - Saure, Daniel A1 - Metzendorf, Maria-Inti A1 - Salzwedel, Annett A1 - Völler, Heinz A1 - Jensen, Katrin A1 - Schmid, Jean-Paul T1 - The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy BT - a systematic review and meta-analysis of randomized and non-randomized studies - the Cardiac Rehabilitation Outcome Study (CROS) T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background The prognostic effect of multi-component cardiac rehabilitation (CR) in the modern era of statins and acute revascularisation remains controversial. Focusing on actual clinical practice, the aim was to evaluate the effect of CR on total mortality and other clinical endpoints after an acute coronary event. Design Structured review and meta-analysis. Methods Randomised controlled trials (RCTs), retrospective controlled cohort studies (rCCSs) and prospective controlled cohort studies (pCCSs) evaluating patients after acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) or mixed populations with coronary artery disease (CAD) were included, provided the index event was in 1995 or later. Results Out of n=18,534 abstracts, 25 studies were identified for final evaluation (RCT: n=1; pCCS: n=7; rCCS: n=17), including n=219,702 patients (after ACS: n=46,338; after CABG: n=14,583; mixed populations: n=158,781; mean follow-up: 40 months). Heterogeneity in design, biometrical assessment of results and potential confounders was evident. CCSs evaluating ACS patients showed a significantly reduced mortality for CR participants (pCCS: hazard ratio (HR) 0.37, 95% confidence interval (CI) 0.20-0.69; rCCS: HR 0.64, 95% CI 0.49-0.84; odds ratio 0.20, 95% CI 0.08-0.48), but the single RCT fulfilling Cardiac Rehabilitation Outcome Study (CROS) inclusion criteria showed neutral results. CR participation was also associated with reduced mortality after CABG (rCCS: HR 0.62, 95% CI 0.54-0.70) and in mixed CAD populations. Conclusions CR participation after ACS and CABG is associated with reduced mortality even in the modern era of CAD treatment. However, the heterogeneity of study designs and CR programmes highlights the need for defining internationally accepted standards in CR delivery and scientific evaluation. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 418 KW - rehabilitation KW - acute coronary syndrome KW - coronary bypass grafting KW - coronary artery disease KW - mortality KW - hospital readmission Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-405346 IS - 418 ER - TY - JOUR A1 - Rauch, Bernhard A1 - Davos, Constantinos H. A1 - Doherty, Patrick A1 - Saure, Daniel A1 - Metzendorf, Maria-Inti A1 - Salzwedel, Annett A1 - Völler, Heinz A1 - Jensen, Katrin A1 - Schmid, Jean-Paul T1 - The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy: A systematic review and meta-analysis of randomized and non-randomized studies - The Cardiac Rehabilitation Outcome Study (CROS) JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Background The prognostic effect of multi-component cardiac rehabilitation (CR) in the modern era of statins and acute revascularisation remains controversial. Focusing on actual clinical practice, the aim was to evaluate the effect of CR on total mortality and other clinical endpoints after an acute coronary event. Design Structured review and meta-analysis. Methods Randomised controlled trials (RCTs), retrospective controlled cohort studies (rCCSs) and prospective controlled cohort studies (pCCSs) evaluating patients after acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) or mixed populations with coronary artery disease (CAD) were included, provided the index event was in 1995 or later. Results Out of n=18,534 abstracts, 25 studies were identified for final evaluation (RCT: n=1; pCCS: n=7; rCCS: n=17), including n=219,702 patients (after ACS: n=46,338; after CABG: n=14,583; mixed populations: n=158,781; mean follow-up: 40 months). Heterogeneity in design, biometrical assessment of results and potential confounders was evident. CCSs evaluating ACS patients showed a significantly reduced mortality for CR participants (pCCS: hazard ratio (HR) 0.37, 95% confidence interval (CI) 0.20-0.69; rCCS: HR 0.64, 95% CI 0.49-0.84; odds ratio 0.20, 95% CI 0.08-0.48), but the single RCT fulfilling Cardiac Rehabilitation Outcome Study (CROS) inclusion criteria showed neutral results. CR participation was also associated with reduced mortality after CABG (rCCS: HR 0.62, 95% CI 0.54-0.70) and in mixed CAD populations. Conclusions CR participation after ACS and CABG is associated with reduced mortality even in the modern era of CAD treatment. However, the heterogeneity of study designs and CR programmes highlights the need for defining internationally accepted standards in CR delivery and scientific evaluation. KW - Rehabilitation KW - acute coronary syndrome KW - coronary bypass grafting KW - coronary artery disease KW - mortality KW - hospital readmission Y1 - 2016 U6 - https://doi.org/10.1177/2047487316671181 SN - 2047-4873 SN - 2047-4881 VL - 23 SP - 1914 EP - 1939 PB - Sage Publ. CY - London ER -