Key result
Post-transplant depression shows no significant association with 5-year mortality after adjustment.
Why the study?
Depression is prevalent in patients with heart failure and after heart transplant, but its prevalence and association with post-transplant outcomes needed evaluation.
Does depression impact clinical outcomes and mortality in adult heart transplant recipients?
Cohort (n=114)
No
Does depression impact clinical outcomes and mortality in adult heart transplant recipients?
Hazard Ratio: 2.11 (95% CI 0.18–25.27)
Absolute Event Rate: 30% vs 9.5%
p-value: p=.556
While post-transplant depression is associated with a more complicated clinical course and higher unadjusted 5-year mortality, it is not an independent predictor of mortality after adjusting for clinical severity.
Depression not independently linked to mortality after adjustment; leaves open its prognostic role in larger heart transplant cohorts.
BACKGROUND: Depression is prevalent in patients with heart failure and after heart transplant. We identified the prevalence of pre- and post-transplant depression and its association with clinical characteristics and post-transplant outcomes. METHODS: We reviewed 114 adults transplanted 1/1/2015 to 12/31/2015 and identified patients with pre- and post-transplant depression. Clinical characteristics and outcomes were compared. RESULTS: Of 114 patients, 35.1% had pre-transplant depression and 26.3% had post-transplant depression. Patients with post-transplant depression within the first year were significantly more likely to have acute rejection (10% vs 0%), longer intensive care unit (11.7 days vs 7.8 days) and hospital stay (31.7 days vs 16.3 days), and discharge to inpatient rehabilitation (26.7% vs 8.3%). Patients with post-transplant depression within the first year had significantly higher 5-year mortality (30% vs 9.5%, p = .009). However, after adjustment for total artificial heart/biventricular assist device, acute rejection, intensive care unit, and hospital length of stay, this relationship was no longer significant (HR 2.11; 95% CI 0.18-25.27; p = .556). CONCLUSIONS: Depression is common among heart transplant candidates and recipients. While pre-transplant depression did not impact outcomes, patients with post-transplant depression were more likely to have had a complicated course, suggesting the need for increased vigilance regarding depression in such patients.
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Rosa et al. (2020) conducted a cohort in Heart transplant (n=114). Post-transplant depression vs. No post-transplant depression was evaluated on 5-year mortality (HR 2.11, 95% CI 0.18-25.27, p=.556). Post-transplant depression was associated with higher unadjusted 5-year mortality (30% vs 9.5%), but this was not significant after adjustment (HR 2.11; 95% CI 0.18-25.27; p=0.556).
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