Abstract 14281: Predictors of Fatigue in the Presence of Coronary Heart Disease
Background: Fatigue may be an important warning sign before an acute myocardial infarction (AMI). Prior to establishing the importance of fatigue in AMI, it is critical to examine the presence of fatigue in stable coronary heart disease (CHD) patients.
Purpose: The purpose of this novel study was to describe and determine predictors of fatigue in stable CHD.
Method: Stable CHD patients (N = 102) were recruited from one urban and one rural cardiology clinic. Fatigue, depression, and health-related quality of life were measured with the Fatigue Symptom Inventory (FSI), Patient Health Questionnaire-9 (PHQ-9), and Short Form 36 (SF-36).
Results: The majority of subjects were men (64%), non-Hispanic White (56%), and high school graduates (83%). Race, income, and education did not influence fatigue severity or interference from fatigue. Sixty-five percent of the sample reported clinically meaningful fatigue and 40% of subjects reported fatigue more than one-half the week with fatigue lasting more than one-half the day. Women reported more interference from fatigue (M = 3.28 ± 2.71) than men (M = 1.99 ± 2.03; t = 2.74, p < .01). Subjects whose PHQ-9 score was indicative of depression reported more interference from fatigue (M = 3.85 ± 2.37 vs. M = 1.26 ± 1.60; t = 6.55, p < .001) and higher levels of fatigue severity on the FSI and the SF-36 vitality subscale (p < .001) compared to those with no depression (PHQ-9 < 5). Depression was the sole predictor of FSI Interference scores (R2 = .43; p < .01) in a multivariate regression model with age, gender, and PHQ-9 scores. Though 46% of participants had a PHQ-9 score indicative of mild or major depression (PHQ-9 ≥ 5), only 12% of subjects had depression in their medical records.
Conclusion: The majority of stable CHD patients reported fatigue. This baseline fatigue needs to be accounted for when considering the symptoms of AMI. Further research is needed to identify whether changes in fatigue can signal an impending acute event. Depression was not consistently documented in the medical record; therefore, it is imperative that healthcare providers ask about depressed mood in order to manage co-morbid symptoms. More research is needed to fully explore the influence of gender and depression on fatigue in this stable but high risk population.
- © 2013 by American Heart Association, Inc.