{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T11:55:58Z","timestamp":1792756558102,"version":"4.5.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,5,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In adults with acquired heart disease, depression is common and associated with adverse outcomes. Depression may also be important in adults with congenital heart disease (\n                      <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We conducted a cohort study of outpatients with\n                      <jats:styled-content style=\"fixed-case\">CHD,<\/jats:styled-content>\n                      aged \u226518\u00a0years, enrolled in a prospective biobank between 2012 and 2017. Clinical data were extracted from medical records. Survival analysis assessed the relationship between depression, defined by a history of clinical diagnosis of major depression, with all\u2010cause mortality and a composite outcome of death or nonelective cardiovascular hospitalization. A total of 1146 patients were enrolled (age, 38.5\u00b113.8\u00a0years; 49.6% women). Depression had been diagnosed in 219 (prevalence=19.1%), and these patients were more likely to have severely complex\n                      <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n                      (41.3% versus 33.7%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.028), cyanosis (12.1% versus 5.7%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.003), and worse functional class (\u2265\n                      <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>\n                      ; 33.3% versus 20.4%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001), and to be taking antidepressant medication at time of enrollment (68.5% versus 5.7%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). Depression was associated with biomarkers indicative of inflammation (hsCRP [high\u2010sensitivity C\u2010reactive protein], 1.71 [25th\u201375th percentile, 0.82\u20134.47] versus 1.10 [0.45\u20132.40];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) and heart failure (NT\u2010proBNP [N\u2010terminal pro\u2010B\u2010type natriuretic peptide], 190 [92\u2013501] versus 111 [45\u2013264];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). During follow\u2010up of 605\u00b1547\u00a0days, 137 participants (12.0%) experienced the composite outcome, including 33 deaths (2.9%). Depression was associated with increased risk for both all\u2010cause mortality (multivariable hazard ratio, 3.0; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 1.4\u20136.4;\n                      <jats:italic>P<\/jats:italic>\n                      =0.005) and the composite outcome (multivariable hazard ratio, 1.6; 95% CI, 1.1\u20132.5;\n                      <jats:italic>P<\/jats:italic>\n                      =0.025), adjusting for age, sex, history of atrial arrhythmia, systolic ventricular function,\n                      <jats:styled-content style=\"fixed-case\">CHD<\/jats:styled-content>\n                      complexity, and corrected QT interval.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In adults with CHD, major depression is associated with impaired functional status, heart failure, systemic inflammation, and increased risk for adverse outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.014820","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T05:10:21Z","timestamp":1588050621000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":48,"title":["Prevalence and Prognostic Association of a Clinical Diagnosis of Depression in Adult Congenital Heart Disease: Results of the Boston Adult Congenital Heart Disease Biobank"],"prefix":"10.1161","volume":"9","author":[{"given":"Matthew R.","family":"Carazo","sequence":"first","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital Boston MA"},{"name":"Department of Medicine Brigham and Women's Hospital Boston MA"},{"name":"Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan S.","family":"Kolodziej","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Brigham and Women's Hospital Boston MA"},{"name":"Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth S.","family":"DeWitt","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine A.","family":"Kasparian","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital Boston MA"},{"name":"Harvard Medical School Boston MA"},{"name":"Discipline of Paediatrics School of Women's and Children's Health The University of New South Wales Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane W.","family":"Newburger","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital Boston 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