Key result
Severe depressive symptoms were independently associated with increased all-cause mortality in patients with CHF and implanted CRT devices (HR 2.92; 95% CI 1.17-7.32; p=0.02).
Why the study?
The study was conducted to assess the association between depression and all-cause mortality in patients with congestive heart failure after cardiac resynchronization therapy.
Do severe depressive symptoms increase all-cause mortality in patients with congestive heart failure after cardiac resynchronization therapy?
Cohort (n=156)
Do severe depressive symptoms increase all-cause mortality in patients with congestive heart failure after cardiac resynchronization therapy?
Hazard Ratio: 2.92 (95% CI 1.17–7.32)
p-value: p=0.02
Severe depressive symptoms are an independent predictor of all-cause mortality in patients with heart failure who have received cardiac resynchronization therapy.
Depression may flag higher post-CRT mortality risk; leaves open whether screening or treatment improves survival.
PURPOSE: to assess the association between depression and all-cause mortality in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT). MATERIALS AND METHODS: We enrolled in this study 156 patients (mean age 55.3±9.6 years) with CHF and implanted devices for CRT. Mean duration of follow-up was 51.6±33.4 months. The Beck Depression Inventory (BDI) was used to evaluate depressive symptoms (DS); DS were considered absent for a score 0-9, mild to moderate - 10-18, severe - ≥19. For assessment of association of DS and mortality we used multivariate Cox proportional hazards regression model with estimation of hazard ratios (HR) with 95 % confidence intervals (95 %CI). RESULTS: Average Beck Depression Inventory score was 12.4±8.3. In 66 patients (42.3 %) there were no DS, 57 patients (36.5 %) had mild, and 33 (21.2 %) - severe DS. These groups did not differ by main clinical-functional and laboratory indicators. Among individuals without DS prevailed men (90.9 vs. 69.7 % among those with severe DS, p=0.007). Hypercholesterolemia was more frequent in patients with DS (63.3 vs. 43.9 % in patients without DS, p=0.02). During follow-up 33 patients died (21.2 %). Adjusted HR of death from all-causes for DS score as continuous parameter was 1.05, 95 % CI 1.01-1.09, p=0.02. Patients without DS were used as reference (HR=1.0) in analysis of categorical indicator. HR was 1.08, 95 % CI 0.46-2.54, p=0.9 in patients with mild, and 2.92, 95 % CI 1.17-7.32, p=0.02 - with severe DS. CONCLUSION: DS were associated with gender and hypercholesterolemia. Severe DS were independently associated with all-cause mortality in patients with CHF and implanted CRT devices.
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Пушкарев et al. (2019) conducted a cohort in Congestive heart failure (CHF) after cardiac resynchronization therapy (CRT) (n=156). Severe depressive symptoms vs. No depressive symptoms was evaluated on All-cause mortality (HR 2.92, 95% CI 1.17-7.32, p=0.02). Severe depressive symptoms were independently associated with increased all-cause mortality in patients with CHF and implanted CRT devices (HR 2.92; 95% CI 1.17-7.32; p=0.02).
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