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Depression and all-cause mortality in patients with congestive heart failure and an implanted cardiac device

Georgiy S Pushkarev1, Vadim A Kuznetsov, Yakov A Fisher

  • 1Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia. pushcarov@mail.ru.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|September 12, 2018
PubMed

Insights

Depression significantly increases mortality risk in patients with congestive heart failure (CHF) and cardiac devices. Severe depressive symptoms were linked to a threefold higher risk of death, highlighting the importance of mental health assessment in CHF care.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Congestive heart failure (CHF) is a chronic condition associated with increased mortality.
  • Patients with CHF often have co-occurring mental health conditions, including depression.
  • Implanted cardiac devices are common in CHF management, but the interplay between depression and outcomes in these patients is not fully understood.

Purpose of the Study:

  • To investigate the association between depression and all-cause mortality in patients with CHF and an implanted cardiac device.
  • To quantify the risk of mortality associated with varying levels of depressive symptoms in this population.

Main Methods:

  • A cohort of 260 patients with CHF and implanted cardiac devices (cardiac resynchronization therapy or implantable cardioverter defibrillator) was followed for a mean of 48.6 months.
  • Depressive symptoms were assessed using the Beck Depression Inventory, categorizing scores into absent, mild-to-moderate, and severe.
  • Cox proportional hazards regression models were used to calculate adjusted hazard ratios (HR) for all-cause mortality, controlling for multiple clinical confounders.

Main Results:

  • During follow-up, 14.2% of patients died.
  • An adjusted hazard ratio of 1.05 (95% CI: 1.01-1.09) indicated an increased risk of all-cause mortality associated with depression.
  • Patients with severe depressive symptoms had a significantly higher risk of all-cause mortality (HR=3.18, 95% CI: 1.31-7.73) compared to those without depression.

Conclusions:

  • Increased depressive symptoms are independently associated with all-cause mortality in patients with CHF and implanted cardiac devices.
  • The severity of depression correlates with the magnitude of mortality risk.
  • These findings underscore the critical need to address depression in the management of CHF patients with cardiac devices.
Abstract

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