Kazue Kuwahara

Publications (2)5.12 Total impact

• Article: Depression and outcomes in hospitalized Japanese patients with cardiovascular disease. - Prospective single-center observational study-.

  Tsuyoshi Suzuki, Tsuyoshi Shiga, Kazue Kuwahara, Sayaka Kobayashi, Shinichi Suzuki, Katsuji Nishimura, Atsushi Suzuki, Hisako Omori, Fumiaki Mori, Jun Ishigooka, Hiroshi Kasanuki, Nobuhisa Hagiwara
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  ABSTRACT: Several studies have suggested that depression poses a risk in cardiovascular patients. The aim of the present study was to evaluate the prevalence of depression and its effect on cardiovascular events and mortality in Japanese inpatients with cardiovascular disease. A total of 505 patients hospitalized with cardiovascular disease (28% female; mean age, 61 ± 14 years; 31% ischemic heart disease; 47% New York Heart Association [NYHA] class II-IV; 25% implantation of pacing devices) were enrolled in the present prospective observational study. The Zung Self-Rating Depression Scale (SDS) was used to screen for depression. The primary outcome was the time to death or cardiovascular event, and the secondary outcome was death. In total, 109 patients (22%) were diagnosed with depression (Zung SDS index score ≥ 60). NYHA class III/IV, defibrillator implantation, and being unmarried were independently associated with depression. During an average follow-up period of 38 ± 15 months, 92 patients (18%) reached the primary outcome. There was a higher incidence of the primary outcome in patients with depression than in those who were not depressed (P<0.01). Depressed patients had a significantly higher rate of mortality than non-depressed patients (P<0.01). Depression was an independent predictor of the primary outcome (hazard ratio, 2.25; 95% confidence interval: 1.30-3.92, P<0.01). Depression was not uncommon in Japanese inpatients with cardiovascular disease and was associated with cardiovascular outcomes.
  Circulation Journal 07/2011; 75(10):2465-73. · 3.77 Impact Factor
• Article: Prevalence and persistence of depression in patients with implantable cardioverter defibrillator: a 2-year longitudinal study.

  Tsuyoshi Suzuki, Tsuyoshi Shiga, Kazue Kuwahara, Sayaka Kobayashi, Shinichi Suzuki, Katsuji Nishimura, Atsushi Suzuki, Koichiro Ejima, Tetsuyuki Manaka, Morio Shoda, Jun Ishigooka, Hiroshi Kasanuki, Nobuhisa Hagiwara
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  ABSTRACT: It is unclear whether depression persists in patients with implantable cardioverter defibrillators (ICDs). We evaluated the prevalence and persistence of depression in ICD patients over a 2-year period. The study included 90 consecutively hospitalized patients. Patients underlying heart disease was 24% coronary artery disease, 29% idiopathic dilated cardiomyopathy, 24% hypertrophic cardiomyopathy, 13% idiopathic VF/long QT syndrome and miscellaneous conditions 11%. A secondary indication for ICD implantation was present in 20 patients. All patients completed the Zung Self-Rating Depression Scale (SDS) at study baseline and at the their routine follow-up visit 2 years after the baseline questionnaire. Delivery of ICD therapies was tracked throughout the 2 years. Depression, indicated by a Zung SDS index score exceeding 60, was present in 29 (32%) of patients at study baseline. Depression was present in 11/51 (21%) patients scheduled to undergo ICD implantation, 2/2 (100%) patients whose device was upgraded to a CRT-D, 3/14 (21%) patients who had undergone pulse generator replacement, 7/14 (50%) patients who experienced electrical storm and 6/9 (66%) patients hospitalized with acute decompensated heart failure. NYHA functional class III was significantly associated with depression at baseline (HR 6.7, 95% CI 1.68-27.2, p = 0.0007). No differences were noted for female gender, demographics, β-blocker use, or LVEF ≤35% (p = ns). Depression was present in 25 (28%) of patients at 2 years follow-up, persisting in 21 (72%) of patients whose Zung SDS scores were elevated at baseline. The median time from ICD shock therapy to completion of the 2 year questionnaire was 9 months (range, 1-22). Patients who were depressed (9/25, 36%) experienced more shocks than non-depressed patients (6/65, 9%) after 2 years (p = 0.002). Depression is not uncommon among patients who meet criteria for ICD implantation and persists over time particularly when functional status is impaired. Depression is associated with a higher incidence shock therapy.
  Pacing and Clinical Electrophysiology 10/2010; 33(12):1455-61. · 1.35 Impact Factor