depression scale-short form: validation of a new 60 second depression screening tool for cardiac...

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ABSTRACTS S24 Abstracts Heart, Lung and Circulation 2008;17S:S1–S209 Fig. 1. Conclusion: We demonstrate that the consumption of Red Bull TM acutely increased platelet reactivity and decreases endothelial function in young adults. As increased platelet reactivity and endothelial dysfunction are predictors for cardiovascular disease further work needs to be done to assess whether consumption of such drinks impact on sudden cardiac events in otherwise healthy fit young subjects. doi:10.1016/j.hlc.2008.05.055 55 Healthy Hearts-Beyond City Limits: Results of a Pilot Screening Program to Identify the Prevalence of Cardio- vascular Risk Factors in Regional Victoria Melinda Carrington , Geraldine Lee, Garry Jennings, Simon Stewart Baker Heart Research Institute, Melbourne, Australia Background: Evidence suggests that rural and remote areas have greater rates of cardiovascular disease (CVD) but there are few data on the prevalence of CVD risk fac- tors in regional Australia. Methods: As part of the “Healthy HeartsBeyond City Lim- its” program, trained personnel evaluated the risk profile of adults in a regional Victorian community using a stan- dardised protocol over a four week period. Results: Overall, 548 participants (52% female, aged 54 ± 16 years) were screened. This represented almost one in ten adults. Average systolic and diastolic blood pres- sure (BP) was 142 ± 22 and 77 ± 11 mmHg, respectively. A total of 54% versus 46% of men and women, respectively, had elevated BP (OR 1.29, 95% CI 1.1–1.5). Average total cholesterol (5.5 ± 1.1 mmol/L) was above recommended limits (4.5 mmol/L) for 79% of participants. Males versus females (3.4 ± 1.0 mmol/L vs. 3.2 ± 1.0 mmol/L) had higher LDL-C (p = .01) and lower HDL-C (1.2 ± 0.4 mmol/L vs. 1.5 ± 0.4 mmol/L, p < .001). Overall, 11% (n = 56) of 12-lead ECGs had a major abnormality. Of the 87 participants (16%) screened positive for potential depression, 49 (56%) had a CES-D score indicative of depression. Further- more, average Forced Vital Capacity and Forced Expiratory Volume in 1 second was 3.5 ± 1.2 L/s and 2.9 ± 1.0 L/s, respectively. Conclusion: There appears to be a high level of CVD risk in regional Victoria reinforcing the need for effective and sustainable CVD prevention clinics to support the local health care services and facilities. doi:10.1016/j.hlc.2008.05.056 56 Depression Scale-Short Form: Validation of a New 60 Sec- ond Depression Screening Tool for Cardiac Patients William Shi 1,, Nibo Wu 1 , Andrew Stewart 2 , Deidre Toia 2 , David Hare 1 1 University of Melbourne, Melbourne, Victoria, Australia; 2 Austin Health, Melbourne, Victoria, Australia Objective: The cardiac depression scale (CDS) can reliably and responsively assess the full range of depression. A screening instrument is required that can briefly detect all forms of depression in cardiac patients. Method: Responses on the 26 items of the English CDS from 1182 cardiac patients were subjected to factor analysis with maximum likelihood extraction and oblique rota- tion. The new Depression Scale-Short Form (DS-SF) items were selected on factor loading strength and face validity. The DS-SF was administered to a separate, representa- tive 146 patient cohort. Internal consistency was assessed using Cronbach’s alpha and convergent validity by com- parison with the full CDS and Beck Depression Inventory (BDI). Blinded clinical diagnosis of DSM-IV major and minor depression was undertaken using the Mini Inter- national Neuropsychiatric Interview. Receiver Operator Characteristic (ROC) curves were constructed. 34 partic- ipants completed the DS-SF one week apart to evaluate test–retest reproducibility. Result: A five-item scale was the most robust solution. The scale demonstrated high internal consistency (α = 0.82) and convergent validity with the CDS (r = 0.90, p < 0.0001) and BDI (r = 0.77, p < 0.0001). Scores demonstrated nor- mal distribution with mean 14.3 ± 6.55 S.D. A cut-off score of 17 provided 91% sensitivity and 82% specificity for detecting major depression. A score 14 provided 92% sensitivity and 71% specificity for any depression. The 1- week test–retest reproducibility revealed S.D. of difference 3.8 and r = 0.82 (p < 0.0001). Conclusion: The DS-SF is a reliable, sensitive and repro- ducible instrument for detecting depression in cardiac patients. doi:10.1016/j.hlc.2008.05.057

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Page 1: Depression Scale-Short Form: Validation of a New 60 Second Depression Screening Tool for Cardiac Patients

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S24 Abstracts Heart, Lung and Circulation2008;17S:S1–S209

Fig. 1.

Conclusion: We demonstrate that the consumption of RedBullTM acutely increased platelet reactivity and decreasesendothelial function in young adults. As increased plateletreactivity and endothelial dysfunction are predictors forcardiovascular disease further work needs to be doneto assess whether consumption of such drinks impacton sudden cardiac events in otherwise healthy fit youngsubjects.

doi:10.1016/j.hlc.2008.05.055

55Healthy Hearts-Beyond City Limits: Results of a PilotScreening Program to Identify the Prevalence of Cardio-vascular Risk Factors in Regional Victoria

Melinda Carrington ∗, Geraldine Lee, Garry Jennings,Simon Stewart

Baker Heart Research Institute, Melbourne, Australia

Background: Evidence suggests that rural and remoteareas have greater rates of cardiovascular disease (CVD)but there are few data on the prevalence of CVD risk fac-tors in regional Australia.Methods: As part of the “Healthy Hearts—Beyond City Lim-its” program, trained personnel evaluated the risk profileof adults in a regional Victorian community using a stan-dardised protocol over a four week period.

sustainable CVD prevention clinics to support the localhealth care services and facilities.

doi:10.1016/j.hlc.2008.05.056

56Depression Scale-Short Form: Validation of a New 60 Sec-ond Depression Screening Tool for Cardiac Patients

William Shi 1,∗, Nibo Wu 1, Andrew Stewart 2, DeidreToia 2, David Hare 1

1 University of Melbourne, Melbourne, Victoria, Australia;2 Austin Health, Melbourne, Victoria, Australia

Objective: The cardiac depression scale (CDS) can reliablyand responsively assess the full range of depression. Ascreening instrument is required that can briefly detectall forms of depression in cardiac patients.Method: Responses on the 26 items of the English CDSfrom 1182 cardiac patients were subjected to factor analysiswith maximum likelihood extraction and oblique rota-tion. The new Depression Scale-Short Form (DS-SF) itemswere selected on factor loading strength and face validity.The DS-SF was administered to a separate, representa-tive 146 patient cohort. Internal consistency was assessedusing Cronbach’s alpha and convergent validity by com-parison with the full CDS and Beck Depression Inventory(BDI). Blinded clinical diagnosis of DSM-IV major and

Results: Overall, 548 participants (52% female, aged54 ± 16 years) were screened. This represented almost onein ten adults. Average systolic and diastolic blood pres-sure (BP) was 142 ± 22 and 77 ± 11 mmHg, respectively. Atotal of 54% versus 46% of men and women, respectively,had elevated BP (OR 1.29, 95% CI 1.1–1.5). Average totalcholesterol (5.5 ± 1.1 mmol/L) was above recommendedlimits (4.5 mmol/L) for 79% of participants. Males versusfemales (3.4 ± 1.0 mmol/L vs. 3.2 ± 1.0 mmol/L) had higherLDL-C (p = .01) and lower HDL-C (1.2 ± 0.4 mmol/L vs.1.5 ± 0.4 mmol/L, p < .001). Overall, 11% (n = 56) of 12-leadECGs had a major abnormality. Of the 87 participants(16%) screened positive for potential depression, 49 (56%)had a CES-D score indicative of depression. Further-more, average Forced Vital Capacity and Forced ExpiratoryVolume in 1 second was 3.5 ± 1.2 L/s and 2.9 ± 1.0 L/s,respectively.Conclusion: There appears to be a high level of CVD riskin regional Victoria reinforcing the need for effective and

minor depression was undertaken using the Mini Inter-national Neuropsychiatric Interview. Receiver OperatorCharacteristic (ROC) curves were constructed. 34 partic-ipants completed the DS-SF one week apart to evaluatetest–retest reproducibility.Result: A five-item scale was the most robust solution. Thescale demonstrated high internal consistency (α = 0.82)and convergent validity with the CDS (r = 0.90, p < 0.0001)and BDI (r = 0.77, p < 0.0001). Scores demonstrated nor-mal distribution with mean 14.3 ± 6.55 S.D. A cut-off scoreof ≥17 provided 91% sensitivity and 82% specificity fordetecting major depression. A score ≥14 provided 92%sensitivity and 71% specificity for any depression. The 1-week test–retest reproducibility revealed S.D. of difference3.8 and r = 0.82 (p < 0.0001).Conclusion: The DS-SF is a reliable, sensitive and repro-ducible instrument for detecting depression in cardiacpatients.

doi:10.1016/j.hlc.2008.05.057