Turk Kardiyol Dern Ars. Ahead of Print: TKDA-04134 | DOI: 10.5543/tkda.2018.04134
Depression And All-Cause Mortality In Patients With Congestive Heart Failure With Implanted Cardiac Devices
Georgiy S. Pushkarev
, Vadim A. Kuznetsov, Yakov A. Fisher, Anna M. Soldatova, Tatyana N. Enina
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
The purpose of the study was to assess the association between depression and all-cause mortality in patients with congestive heart failure (CHF) and implanted cardiac devices.Keywords:
METHODS The study enrolled 260 patients (mean age 56.8±10.0 years, 83.1% men) with CHF and implanted cardiac devices (156 patients with implanted cardiac devices for resynchronisation therapy, 104 patients - with implantable cardioverter defibrillators). Mean duration of follow-up was 48.6±32.2 months. The Beck Depression Inventory (BDI) was used to measure depressive symptoms. Depression was considered absent for a score between 0 and 9, mild to moderate between 10 and 18, severe if more 19. Cox proportional hazards regression model was used to estimate hazard ratios (HR) with 95% confidence interval (95% CI) for impact of depression on all-cause mortality. HR was calculated after adjustment for the following confounders: age, gender, smoking status, hypertension, diabetes mellitus, body mass index, hypercholesterolemia, left ventricular ejection fraction, number of hemodynamically significant lesions of the coronary arteries and the type of the implanted cardiac devices.
RESULTS During follow-up period 37 patients died (14.2%). Adjusted HR for all-cause mortality on depression score was 1.05, 95% CI 1.01 1.09. Patients without depression were accepted as a reference group with HR=1.0 for analysis of categorical indicator. HR was 1.32, 95% CI 0.57 3.03 in patients with mild depressive symptoms and 3.18, 95% CI 1.31 7.73 in patients with severe depressive symptoms.
CONCLUSION Increased depressive symptoms are independently associated with all-cause mortality in patients with CHF and implanted cardiac devices.
depression, congestive heart failure, psychosocial risk factors, cardiac resynchronisation therapy.
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Corresponding Author: Georgiy S. Pushkarev, Russia