Mild Depression Predicts Long-Term Mortality After Acute Myocardial Infarction: A 25-Year Follow-Up.

Background: Past studies have found that depression is an independent predictor of death in patients after acute myocardial infarction (AMI). Our aim was to investigate whether the adverse effect upon mortality of depression, including mild levels, persisted up to 25 years.

Methods: We used an historical design to study patients who had been consecutively admitted to hospital after transmural AMI during the 1980s and enrolled in an exercise training trial.

Patients want to know about the 'cardiac blues'.

Background: Much attention has been given to identifying and supporting the minority of patients who develop severe clinical depression after a cardiac event. However, relatively little has been given to supporting the many patients who experience transient but significant emotional disturbance that we term the 'cardiac blues'.

Objective: The aim of this study was to investigate patients' preferences regarding information provision about cardiac blues.

Determinants of Physical Activity Guideline Attainment in Australian Cardiac Patients: A 12-Month Study.

Purpose: Little is known about the type and intensity of physical activity (PA) reported by cardiac patients during the first year after hospitalization and whether patients are meeting recommended PA guidelines. In addition, the achievement of PA guideline over the course of recovery is largely unknown.

Methods: A total of 136 patients consecutively admitted to 2 Australian hospitals after acute myocardial infarction (31%), or to undergo bypass surgery (29%) or percutaneous coronary intervention (40%), were interviewed at 6 weeks and at 4 and 12 months after admission.

Bundap Marram Durn Durn: Engagement with Aboriginal women experiencing comorbid chronic physical and mental health conditions.

Objective: To explore antecedents of health service engagement and experience among urban Aboriginal people with comorbid physical and mental health conditions.

Methods: Focus groups and interviews were conducted with Aboriginal people who had comorbid health conditions and were accessing Aboriginal and/or mainstream services.

Results: Nineteen participants, all women, were recruited.

Resumption of work after acute coronary syndrome or coronary artery bypass graft surgery.

Background: Return to work is an important indicator of recovery after acute cardiac events. This study aimed to determine rates of work resumption and identify predictors of non-return to work and delayed resumption of work.

Methods: 401 currently employed patients consecutively admitted after acute coronary syndrome or to undergo coronary artery bypass graft surgery were recruited.

Physical inactivity at leisure and work: a 12-month study of cardiac patients.

Purpose: Physical inactivity has been identified as a distinct health risk. However, little is known about how this can vary at leisure and work in cardiac patients. The aim of this study was to examine the prevalence and predictors of inactivity during leisure and work in the 12 months following a cardiac event in Australian cardiac patients.

Reduction in 2-year recurrent risk score and improved behavioral outcomes after participation in the "Beating Heart Problems" self-management program: results of a randomized controlled trial.

Purpose: While behavior change can improve risk factor profiles and prognosis after an acute cardiac event, patients need assistance to achieve sustained lifestyle changes. We developed the "Beating Heart Problems" cognitive-behavioral therapy and motivational interviewing program to support patients to develop behavioral and cognitive self-management skills. We report the results of a randomized controlled trial of the program.

An integrated secondary prevention group programme reduces depression in cardiac patients.

Objective: Depression is common following an acute cardiac event and can occur at a time when behaviour change is strongly recommended to reduce the risk of further cardiovascular events. The 'Beating Heart Problems' programme was designed to support cardiac patients in behaviour change and mood management.

Methods: The programme was based on cognitive behaviour therapy and motivational interviewing.

Are poor health behaviours in anxious and depressed cardiac patients explained by sociodemographic factors?

Introduction: While there is evidence of poor health behaviours in anxious and depressed cardiac patients, it is possible that sociodemographic factors explain these associations. Few previous studies have adequately controlled for confounders. The present study investigated health behaviours in anxious and depressed cardiac patients, while accounting for sociodemographic confounders.

Identifying illness perception schemata and their association with depression and quality of life in cardiac patients.

The purpose of this paper is to identify groups of cardiac patients who share similar perceptions about their illness and to examine the relationships between these schemata and psychosocial outcomes such as quality of life and depression. A total of 190 cardiac patients with diagnoses of myocardial infarction, stable angina pectoris or chronic heart failure, completed a battery of psychosocial questionnaires within four weeks of their admission to hospital. These included the Brief Illness Perceptions Questionnaire (BIPQ), Beck Depression Inventory II (BDI II) and The MacNew Health-related Quality of Life instrument (MacNew).

Lifestyle and physiological risk factor profiles six weeks after an acute cardiac event: are patients achieving recommended targets for secondary prevention?

Background: People who have had a cardiac event are at increased risk of a subsequent event and death and are, therefore, the priority for preventive cardiology in Australia and elsewhere. Guidelines for physiological and lifestyle risk factors have been developed to encourage risk reduction as a means of secondary prevention. The aim of the present study was to investigate achievement of recommended risk factor targets in a sample of Australian cardiac patients.

Changes in mood states after coronary artery bypass graft surgery.

Few studies have investigated the change in mood states, such as anger, fatigue and confusion, after coronary artery bypass graft surgery (CABGS). The aim of this study was to describe the progression of these mood states over time and to determine the factors associated with these trajectories. The Profile of Mood States (POMS) was administered to 182 CABGS patients prior to surgery and at two and six months post-operatively.

Everyday cognitive functioning in cardiac patients: relationships between self-report, report of a significant other and cognitive test performance.

Candidates for cardiac bypass surgery often experience cognitive decline. Such decline is likely to affect their everyday cognitive functioning. The aim of the present study was to compare cardiac patients' ratings of their everyday cognitive functioning against significant others' ratings and selected neuropsychological tests.

An evaluation of self-report physical activity instruments used in studies involving cardiac patients.

Purpose: Given the importance of physical activity (PA) in cardiac rehabilitation and prevention, measuring it in a valid and reliable manner is a practical challenge. Measuring self-reported PA in elderly cardiac patients can be problematic because of the need to assess many activities of short duration that may occur as part of routine daily functions. The primary purpose of this article was to identify and evaluate instruments that have been used over the last 15 years in studies of cardiac patients.

Anxiety and depression after coronary artery bypass graft surgery: most get better, some get worse.

Background: To target interventions, patients at risk for poor outcomes after a cardiac event need to be identified. We investigated trajectories of anxiety and depression after coronary artery bypass graft surgery (CABGS) and identified patients at risk of persistent or worsening anxiety and depression.

Methods: A consecutive sample of 184 patients on the waiting list for CABGS at The Royal Melbourne Hospital completed self-report questionnaires before surgery, and at 2 and 6 months postsurgery.

Cardiac rehabilitation program attendance after coronary artery bypass surgery: overcoming the barriers.

Objective: To investigate rates and predictors of cardiac rehabilitation (CR) attendance after coronary artery bypass graft surgery (CABGS) at Royal Melbourne Hospital (RMH), Victoria, where current best practice referral and recruitment strategies have been adopted.

Design, Setting And Participants: Prospective cohort study of 184 patients who underwent CABGS at RMH between July 2001 and April 2004. Patients completed questionnaires pre-operatively, and 170 patients (92%) had their CR attendance tracked after referral to CR either at RMH or elsewhere.

Living alone predicts 30-day hospital readmission after coronary artery bypass graft surgery.

Background: Earlier studies show that medical factors and disease severity predict early readmission to hospital after coronary artery bypass graft surgery (CABGS). Few studies have investigated psychosocial predictors. This study investigated medical, sociodemographic and psychosocial predictors of 30-day hospital readmission.

Emotional and adjustment issues faced by cardiac patients seen in clinical practice: a qualitative survey of experienced clinicians.

Purpose: Many cardiac patients experience psychological difficulties after a cardiac event including anxiety, depressed mood, adjustment difficulties, and feelings of grief and loss. There is a vast literature on the psychological adjustment of cardiac patients including reports by individual practitioners into the emotional difficulties of these patients. However, no previous study has surveyed therapists collectively about their experiences working with cardiac patients.

Recall of information received in hospital by female cardiac patients.

Background: The type and source of health information supplied to patients following cardiac events significantly improve adherence and health behaviours. The impact of health information upon female patients, however, is not well documented. This study investigates women's recall of the type and source of information provided to them in hospital about resuming daily activities after a cardiac event.

Trajectories and predictors of anxiety and depression in women during the 12 months following an acute cardiac event.

Objectives: Many previous investigations of the recovery of emotional well-being, particularly the resolution of depression, following an acute cardiac event assume that all patients follow a similar, linear trajectory. However, it is possible that there are different groups of patients who follow different trajectories. This study tested for multiple trajectories of anxiety and depression and identified the characteristics of patients most at risk for persistent or worsening anxiety and depression in the 12 months following their cardiac event.

Trajectories of recovery of quality of life in women after an acute cardiac event.

Objectives: Female cardiac patients' health-related quality of life (HRQoL) during the first year after an acute cardiac event was compared with age-weighted Australian population norms. The impact of age, event type and cardiac rehabilitation (CR) programme attendance on recovery was assessed.

Methods: The short form 36-item health survey (SF-36) was administered to 229 women aged from 36 to 84 years consecutively admitted to 4 hospitals after acute myocardial infarction (AMI) or to undergo coronary artery bypass graft surgery (CABGS).

Predictors of cognitive function in candidates for coronary artery bypass graft surgery.

Candidates for coronary artery bypass graft surgery have been found to exhibit reduced cognitive function prior to surgery. However, little is known regarding the factors that are associated with pre-bypass cognitive function. A battery of neuropsychological tests was administered to a group of patients listed for bypass surgery (n = 109).

Cognitive function in candidates for coronary artery bypass graft surgery.

Background: While many studies have investigated cognitive impairments in patients after coronary artery bypass graft surgery, very few have closely evaluated presurgical cognitive functioning of bypass candidates.

Methods: A battery of neuropsychologic tests was administered to a consecutive series of patients listed for bypass surgery (n = 109). Cognitive function of bypass candidates was compared with that of a healthy control group (n = 25) and published test norms.

Health related quality of life trajectories and predictors following coronary artery bypass surgery.

Background: Many studies have demonstrated that health related quality of life (HRQoL) improves, on average, after coronary artery bypass graft surgery (CABGS). However, this average improvement may not be realized for all patients, and it is possible that there are two or more distinctive groups with different, possibly non-linear, trajectories of change over time. Furthermore, little is known about the predictors that are associated with these possible HRQoL trajectories after CABGS.

Neurocognitive outcomes in off-pump versus on-pump bypass surgery: a randomized controlled trial.

Background: Cognitive difficulties have been reported after coronary artery bypass graft surgery using cardiopulmonary bypass. However, the cognitive benefit of off-pump surgery remains unclear.

Methods: Consecutively listed candidates for elective bypass were randomly assigned to either off-pump or on-pump techniques (n = 107).