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Depression and outcome among veterans with implantable cardioverter defibrillators with or without cardiac

Alaa A Shalaby1, Genevieve E Brumberg, Lauren Pointer

  • 1University of Pittsburgh Medical Center and Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.

Pacing and Clinical Electrophysiology : PACE
|February 14, 2014
PubMed

Insights

Depression is common in veterans with implantable cardioverter-defibrillators (ICDs). This study found that depression is linked to worse heart failure outcomes and increased mortality risk in these patients.

Area of Science:

  • Cardiology
  • Psychiatry
  • Medical Devices

Background:

  • The impact of depression on outcomes for implantable cardioverter-defibrillator (ICD) recipients is not fully understood.
  • This study investigated the prevalence of depression and its association with heart failure (HF) outcomes in veterans with ICDs.

Purpose of the Study:

  • To assess the prevalence of depression among veterans receiving ICDs.
  • To determine the association between depression and heart failure severity and outcomes in this population.

Main Methods:

  • Analysis of data from the Outcomes among Veterans with Implantable Defibrillators Registry (2005-2010).
  • Examined cross-sectional associations of depression with HF functional class.
  • Assessed the association of depression with the composite outcome of mortality or HF hospitalization over a mean follow-up of 2.7 years.

Main Results:

  • Depression was prevalent in 43% of the 3,862 patients studied.
  • Depression was associated with advanced HF functional class (OR for class III: 1.65, class IV: 1.73).
  • Patients with depression had a higher risk of mortality or HF hospitalization (HR: 1.25 after adjustment).

Conclusions:

  • Depression is a significant issue among veterans with ICDs.
  • Depression is associated with increased heart failure severity.
  • Depression independently predicts adverse outcomes, including mortality or hospitalization, in ICD recipients.
Abstract

Keywords:
depressionheart failureimplantable cardiac defibrillatormortality

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