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Antidepressant use, depression, and survival in patients with heart failure

Christopher M O'Connor1, Wei Jiang, Maragatha Kuchibhatla

  • 1Department of Medicine, Duke Clinical Research Institute, Duke University Medical Center, 2400 N Pratt St, Box 3356, Durham, NC 27705, USA. oconn002@mc.duke.edu

Archives of Internal Medicine
|November 13, 2008
PubMed

Insights

Depression, not antidepressant use, is linked to higher mortality in heart failure patients. This study clarifies that treating depression is crucial for improving outcomes in cardiac patients.

Area of Science:

  • Cardiology
  • Psychiatry
  • Clinical Research

Background:

  • Antidepressant use in cardiac patients may be linked to increased mortality.
  • Depression itself is also associated with higher mortality in heart failure patients.
  • The independent effect of antidepressants versus depression on mortality is unclear.

Purpose of the Study:

  • To investigate the association between long-term mortality and antidepressant use in heart failure patients.
  • To determine if depression or antidepressant use is the primary driver of increased mortality.

Main Methods:

  • 1006 patients with heart failure (ejection fraction ≤35%) were studied.
  • Patients were assessed for depression using the Beck Depression Inventory (BDI) and antidepressant use.
  • Long-term mortality was tracked annually over a mean follow-up of 972 days.

Main Results:

  • 42.7% of participants died during the follow-up period.
  • Unadjusted analysis showed antidepressant use was associated with increased mortality.
  • After controlling for confounders, depression remained significantly associated with increased mortality, while antidepressant use did not.

Conclusions:

  • Depression, identified by a BDI score ≥10, is independently associated with increased long-term mortality in heart failure patients.
  • Antidepressant use, including selective serotonin reuptake inhibitors (SSRIs), was not found to be an independent predictor of mortality.
  • Findings suggest focusing on managing depression is key to improving survival in this patient population.
Abstract

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