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G S Pushkarev1, V A Kuznetsov, Y A Fisher

  • 1Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science. pushkarev@cardio.tmn.ru.

Kardiologiia
|February 4, 2019
PubMed
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Severe depressive symptoms (DS) significantly increase the risk of all-cause mortality in patients with congestive heart failure (CHF) receiving cardiac resynchronization therapy (CRT). This highlights the importance of managing depression in this population.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Congestive heart failure (CHF) is a chronic condition associated with increased mortality.
  • Cardiac resynchronization therapy (CRT) is a treatment for CHF, but patient outcomes can be affected by comorbidities.
  • Depression is a common comorbidity in CHF patients, potentially impacting prognosis.

Purpose of the Study:

  • To investigate the association between depressive symptoms (DS) and all-cause mortality.
  • To assess this association specifically in patients with CHF who have undergone CRT implantation.

Main Methods:

  • A cohort of 156 CHF patients with implanted CRT devices was followed for a mean of 51.6 months.
  • Depressive symptoms were assessed using the Beck Depression Inventory (BDI), categorizing them as absent, mild-to-moderate, or severe.

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  • Multivariate Cox proportional hazards regression models were employed to analyze the association between DS and mortality, controlling for relevant factors.

    • Main Results:

    • The average BDI score was 12.4±8.3, with 21.2% of patients experiencing severe DS.
    • Severe DS were independently associated with a significantly increased risk of all-cause mortality (HR=2.92, p=0.02).
    • Depressive symptoms were associated with gender and a higher prevalence of hypercholesterolemia.

    Conclusions:

    • Depressive symptoms, particularly severe ones, are independently linked to increased all-cause mortality in CHF patients treated with CRT.
    • These findings underscore the importance of screening for and managing depression in this patient population.
    • The association of DS with gender and hypercholesterolemia warrants further investigation.