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Depression increases the risk of mortality in patients with heart failure: A meta-analysis

Emily C Gathright1, Carly M Goldstein2, Richard A Josephson3

  • 1Department of Psychological Sciences, Kent State University, Kent, OH 44240, USA; Alpert Medical School, Brown University, Providence, RI 02903, USA.

Journal of Psychosomatic Research
|February 11, 2017
PubMed

Insights

Depression increases all-cause mortality risk in heart failure (HF) patients, particularly in older adults and those with shorter follow-up periods. Cardiovascular mortality links remain unclear, requiring further investigation.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Depression is a known risk factor for mortality in cardiovascular diseases.
  • Previous research indicates depression predicts adverse outcomes in heart failure (HF) patients.
  • Existing data on depression's effect on mortality in HF are inconclusive.

Purpose of the Study:

  • To conduct a meta-analysis examining the relationship between depression and mortality in heart failure (HF) patients.
  • To aggregate effect size estimates and perform subgroup analyses.

Main Methods:

  • Systematic literature search of prospective studies (1999-2016) in PubMed, PsychINFO, and MEDLINE.
  • Meta-analysis using Comprehensive Meta-Analysis software to compute aggregated hazard ratios.
  • Subgroup analyses based on age and follow-up duration.

Main Results:

  • Eighteen studies met inclusion criteria, with 8 univariate and 14 multivariate estimates showing a link between depressive symptoms and all-cause mortality.
  • Pooled analysis of 3 multivariate studies found no significant association between depressive symptoms and cardiovascular mortality.
  • Depression predicted all-cause mortality in samples with mean age >65 and shorter follow-up durations.

Conclusions:

  • Depression is associated with increased all-cause mortality risk in heart failure patients.
  • The association is stronger in older adults and with shorter follow-up periods.
  • Further research is needed to clarify the relationship between depression and cardiovascular mortality in HF.
Abstract

Keywords:
DepressionHeart failureMeta-analysisMortality

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