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Depression, antidepressants, and long-term mortality in heart failure
Crisanto Diez-Quevedo1, Josep Lupón, Beatriz González
1Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Ctra Canyet, 08916 Badalona, Spain.
International Journal of Cardiology
|April 18, 2012
Summary
Depression in heart failure patients increases mortality risk. While antidepressants and benzodiazepines appear safe, specific drug effects require further study.
Area of Science:
- Cardiology
- Psychiatry
- Pharmacology
Background:
- Heart failure (HF) is a complex condition with significant long-term mortality.
- Depression is a common comorbidity in HF patients, impacting quality of life and potentially prognosis.
- The relationship between depressive symptoms, antidepressant use, and mortality in HF requires further investigation.
Purpose of the Study:
- To evaluate the association between depression and long-term mortality in patients with heart failure.
- To determine if antidepressant use influences survival rates in heart failure patients.
- To explore the safety of specific antidepressant classes and benzodiazepines in this population.
Main Methods:
- A prospective study of 1017 heart failure outpatients from a Spanish tertiary center.
- Assessment of depressive symptoms using the Geriatric Depression Scale and tracking of antidepressant prescriptions.
- Median follow-up of 5.4 years with adjusted hazard ratios (HR) for mortality.
Main Results:
- Depressive symptoms were present in 29.7% at baseline and 21.8% developed de novo during follow-up.
- Depression was associated with increased all-cause mortality (HR, 1.39; 95% CI, 1.15-1.68).
- Antidepressant use was not independently linked to mortality, but benzodiazepines showed a protective effect (HR, 0.70). Fluoxetine was associated with increased mortality.
Conclusions:
- Depressive symptoms significantly increase long-term mortality risk in heart failure patients.
- Current evidence suggests antidepressant and benzodiazepine use is safe for survival in HF.
- Further research is warranted to examine the differential impact of individual antidepressants on HF mortality.
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