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Published on: December 2, 2014

Depression after coronary artery disease is associated with heart failure

Heidi T May1, Benjamin D Horne, John F Carlquist

  • 1Intermountain Medical Center, Cardiovascular Research, Murray, Utah 84157, USA. Heidi.May@imail.org

Journal of the American College of Cardiology
|April 18, 2009
PubMed

Insights

Depression diagnosis after coronary artery disease (CAD) significantly increases heart failure (HF) risk. This association persists regardless of antidepressant medication use, highlighting depression

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Depression is a known risk factor for adverse outcomes in patients with coronary artery disease (CAD).
  • The specific impact of post-CAD depression on the development of heart failure (HF) remains under-investigated.

Purpose of the Study:

  • To determine the influence of a depression diagnosis subsequent to CAD on the incidence of heart failure (HF).
  • To assess if antidepressant medication (ADM) use modifies the relationship between post-CAD depression and HF risk.

Main Methods:

  • A cohort of 13,708 patients diagnosed with CAD (>=70% stenosis) but without prior HF or depression was analyzed.
  • Patients were stratified based on post-CAD depression diagnosis and antidepressant medication (ADM) use.
  • Cox proportional hazards regression models were employed to analyze time to HF diagnosis or death.

Main Results:

  • A post-CAD depression diagnosis was identified in 10.0% of patients.
  • The incidence of HF was substantially higher in patients with post-CAD depression (16.4 per 100) compared to those without (3.6 per 100).
  • Depression was associated with a 50% increased risk of HF incidence (adjusted HR: 1.50, p < 0.0001), irrespective of ADM use.

Conclusions:

  • A diagnosis of depression following CAD is significantly associated with an increased risk of developing heart failure.
  • This increased HF incidence in depressed CAD patients was observed regardless of whether they were treated with antidepressant medication.
  • Further research is warranted to explore the mechanisms underlying depression's effect on HF risk in CAD patients.
Abstract

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