Open AccessImpact of Depressive Symptoms on All-Cause Mortality in Patients with Congestive Heart Failure After Cardiac Resynchronization Therapy
Author(s) -
G. Pushkarev,
В. А. Кузнецов,
Y A Fisher,
А. М. Солдатова,
Anna Sapozhnikova,
Т. Н. Енина
Publication year - 2019
Publication title -
kardiologiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.159
H-Index - 16
eISSN - 2412-5660
pISSN - 0022-9040
DOI - 10.18087/cardio.2019.1.10211
Subject(s) - medicine , heart failure , hazard ratio , cardiac resynchronization therapy , cardiology , depression (economics) , proportional hazards model , beck depression inventory , confidence interval , ejection fraction , anxiety , psychiatry , economics , macroeconomics
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.