P5406Impact of depression on all-cause mortality in patients with congestive heart failure after cardiac resynchronization therapy

Purpose: To assess the association between depression and all-cause mortality in patients with congestive heart failure (CHF) after cardiac resynchronization therapy (CRT). Methods: The study enrolled 156 patients (mean age 55.3±9.6 years, 84% men) with CHF and implanted cardiac devices for resynchronization therapy. Mean duration of follow-up was 51.6±33.4 months. The Beck Depression Inventory (BDI) was used to measure depressive symptoms. Cox proportional hazards regression model was used to estimate hazard ratios (HR) with 95% confidence interval (95% CI) for impact of depression on all-cause mortality. HR was calculated after adjustment for the following confounders: age, gender, smoking status, hypertension, diabetes mellitus, previous myocardial infarction, body mass index, hypercholesterolemia, left ventricular ejection fraction, number of hemodynamically significant lesions of the coronary arteries and functional class of CHF. Results: In 66 patients (42.3%) no symptoms of depression were detected, 57 patients (36.5%) had mild depression and 33 patients (21.2%) had severe symptoms of depression. The major clinical-functional and laboratory parameters did not differ between the groups. Among individuals without symptoms of depression, males prevailed (90.9% in the non-depressed group vs 69.7% in the group with severe depression, p=0.007). Hypercholesterolemia was more frequent in patients with depressive symptoms (43.9% in the non-depressed group vs 63.3% in the group with depressive symptoms, p=0.02). During follow-up period 33 patients died (21.2%). Adjusted HR for all-cause mortality on depression score was 1.05, 95% CI 1.01–1.09, p=0.02. Patients without depression were accepted as a reference group with HR=1.0 for analysis of categorical indicator. HR was 1.08, 95% CI 0.46–2.54, p=0.9 in patients with mild depressive symptoms and 2.92, 95% CI 1.17–7.32, p=0.02 in patients with severe depressive symptoms.