Incidence and prognostic significance of depressive symptoms in peripheral artery disease

Background-we compared the incidence of depression,defined by a geriatric depression score (gds) >6,between people with versus without peripheral artery disease (pad). we determined whether depressive symptoms were associated with increased mortality in people with and without pad. methods and results-nine hundred and fifty-one pad patients and 478 non-pad patients were recruited from chicago medical centers and followed prospectively. at baseline and annually,participants completed the gds (0-15 scale,score >6-depression) and 6-minute walk. cause of death was confirmed with death certificates. the prevalence of a gds >6 at baseline was 186/951 (19.6%) among pad versus 63/478 (13.2%) among non-pad participants (p>0.003). during a mean follow-up of 2.71.2 years,122/712 (17.1%) of participants with pad versus 51/403 (12.7%) without pad developed a gds >6 (p-0.047). adjusting for age,sex,race,comorbidities,and other confounders,pad participants had an increased rate of developing a gds >6 compared to non- pad participants (hazard ratio>1.54 (95% ci-1.05-2.25,p-0.026). this association was not statistically significant after adjusting for 6-minute walk (p>0.258). among pad participants,a baseline gds >6 was associated with increased all-cause mortality,adjusting for confounders (hazard ratio-1.57,95% ci-1.12-2.21,p-0.009). this association was not significant after adjusting for 6-minute walk (p-0.224). conclusions-people with pad have a higher incidence of depressive symptoms than people without pad. in pad,depressive symptoms are associated with increased all-cause and cardiovascular mortality. these associations are explained in part by poorer 6-minute walk among people with pad and among depressed people with pad,respectively. © 2016 the authors.