ArticlePloS one2019
Multi-state models of transitions in depression and anxiety symptom severity and cardiovascular events in patients with coronary heart disease.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Resilience and Depressive Symptoms in Adults With Cardiac Disease: A Systematic Review.The Journal of cardiovascular nursingPooled it
- Therapeutic efficacy and safety of Shexiang Baoxin Pill in relation to anxiety and depression in patients with coronary heart disease.Medicine · 2026Article
- Identifying Important Factors for Depressive Symptom Dynamics in Chinese Middle-Aged and Older Adults Using a Multi-State Transition Model with Feature Selection.Behavioral sciences (Basel, Switzerland) · 2025Article
- Experience of financial hardship and depression: a longitudinal population-based multi-state analysis.Epidemiology and psychiatric sciences · 2025Article
- Comparing Emotionally Focused Therapy vs Transcranial Direct Current Stimulation on Anxiety, Life Quality in CAD Patients During COVID-19.Basic and clinical neuroscience · 2025Article
- Evaluation of an inpatient psychocardiological rehabilitation program in Austria: Psychosocial outcomes of a six-month cohort study.PloS one · 2025Observational
- Evaluating the transitions in care for children presenting with acute asthma to emergency departments: a retrospective cohort study.BMC emergency medicine · 2021Article
- Expression of lncRNA-ANRIL before and after Treatment and Its Predictive Value for Short-Term Survival in Patients with Coronary Heart Disease.BioMed research international · 2021Article
- Roles of Anxiety and Depression in Predicting Cardiovascular Disease Among Patients With Type 2 Diabetes Mellitus: A Machine Learning Approach.Frontiers in psychology · 2021Article
- The Continuum Between Temperament and Mental Illness as Dynamical Phases and Transitions.Frontiers in psychiatry · 2020Review
- Risk Factors for Comorbid Anxiety in Patients with Coronary Heart Disease and Association with Noise Exposure.Noise & healthArticle
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivePatients with coronary heart disease (CHD) commonly suffer from depression and anxiety, yet transitions of symptom severity and cardiovascular events (CVE) over time are not well characterized.
methodsWe included 997 patients with stable CHD from a prospective cohort study. We estimated 5- and 10-year transition probabilities of depression and anxiety symptom severity levels and fatal- and non-fatal adverse CVE. Depression and anxiety symptoms were measured with the Hospital Anxiety and Depression Scale 5 times over 13 years and categorized as no, mild, or moderate/severe symptoms. Using multi-state modeling, we calculated 5- and 10-year transition probabilities for depression and anxiety symptom severity and CVE and calculated transition intensity ratios for factors associated with symptom severity progression and regression.
resultsAt 5 years, only approximately half of participants with moderate or severe symptom severity at baseline transitioned to no symptom severity. Patients with low physical activity (<1x/week or never) had a higher probability of worse symptom severity after 5 and 10 years and a higher probability of a CVE after 5 and 10 years regardless of their depression status at baseline compared to higher physical activity groups. Higher body mass index, <10 years of education, and lower physical activity were associated with depression symptom progression; female and lower physical activity were associated with anxiety symptom progression.
conclusionsPatients with CHD had a consistent burden of depression and anxiety symptoms. Secondary prevention strategies should target depression and anxiety and include a physical activity component.
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