Self-reported anxiety/depression in heart failure patients was associated with increased risks of hospitalization but not mortality after HRQoL adjustment.
Does self-reported anxiety and/or depression increase the risk of hospitalization and death in patients with heart failure across the ejection fraction spectrum?
Anxiety and depression are highly prevalent across all heart failure ejection fraction categories and independently predict increased risks of hospitalization.
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Abstract Background Limited data exist on characteristics and clinical outcomes associated with anxiety and/or depression in heart failure (HF) across the different ejection fraction (EF) categories, particularly when considering aspects of health-related quality of life (HRQoL). Objectives To assess characteristics and clinical outcomes associated with anxiety and/or depression in patients with preserved, mildly reduced, and reduced EF (HFpEF, HFmrEF, and HFrEF). Methods Patients were included from the Swedish Heart Failure Registry in 2008-2023. Anxiety and/or depression levels (none, moderate, or severe) were self-reported using the EuroQoL 5-dimensional questionnaire (EQ5D). Multivariable multinomial regression was used to analyze baseline characteristics independently associated with self-reported anxiety/depression, with and without HRQoL adjustment. Time-to-first HF hospitalization (HFH), all-cause hospitalization, all-cause and cardiovascular (CV) death were assessed using Cox proportional hazards models. Results Among 57,251 patients, 58% reported no, 38% moderate, and 4% severe symptoms of anxiety/depression, with similar distributions across EF categories. Self-reported anxiety/depression were associated with reduced HRQoL components. Without HRQoL adjustment, significant associations included higher NYHA class, liver disease, smoking, female sex, younger age, and inpatient status. Self-reported anxiety/depression levels were associated with higher risks of all outcomes at 12 months. After HRQoL adjustments, self-reported anxiety/depression remained associated with HFH and all-cause hospitalization but not death. Conclusion Self-reported anxiety/depression were common across all HF categories, significantly associated with HRQoL, and associated with increased risk of HFH, all-cause hospitalization and death, but their impact on mortality diminished after adjustment for HRQoL.
Settergren et al. (Thu,) reported a other. Self-reported anxiety/depression in heart failure patients was associated with increased risks of hospitalization but not mortality after HRQoL adjustment.