© 2002 European Society of Cardiology
Clinical depression is common and significantly associated with reduced survival in patients with non-ischaemic heart failure
a Department of Clinical Cardiology, Royal Brompton Hospital London, UK
b Department of Cardiac Medicine, The National Heart & Lung Institute, Imperial College School of Science, Technology, and Medicine, The Royal Brompton Hospital Dovehouse Street, London, SW3 6LY, UK
* Corresponding author. Fax: +44-20-7376-3442 E-mail address: rajaa_faris18{at}hotmail.com E-mail address: r.al-faris{at}ic.ac.uk
 |
Abstract |
|---|
Several studies have shown that depression is an important predictor of morbidity and mortality in patients with ischaemic heart failure. We have investigated whether clinically recognised depression is linked to mortality in patients with non-ischaemic heart failure due to dilated cardiomyopathy (DCM) in the Royal Brompton Hospital (RBH), a tertiary cardiac centre located in London, UK. We retrospectively examined a cohort of 396 consecutive adult patients with DCM who satisfied our inclusion and exclusion criteria identified from an echocardiographic database and the hospital medical records. Mean age was 53±15 years. In all, 83 patients (21%) were clinically depressed, the majority of which (60%) were taking antidepressant therapy. After a follow-up period of 48 months, 83 (21%) patients died, 15 (4%) underwent cardiac transplantation and 130 (33%) were readmitted; 29 (35%) of the deaths and 40 (31%) of the readmissions were among clinically depressed patients. After 5 years, clinically depressed patients had significantly higher mortality and readmission rates than non-depressed; 36 vs. 16% (hazards ratio for death, 3.0; 95% CI, 1.4–6.4; P=0.004), and 87 vs. 74% (hazards ratio for readmission, 0.25; 95% CI, 0.07–0.90; P=0.03), respectively. The risk of depression was greatly increased in the presence of other recognised adverse clinical variables at baseline. Depression increases the risk of death and readmission in patients with heart failure secondary to non-ischaemic DCM. The risk associated with depression appears to be greatest among patients with milder disease, those with a shorter duration of symptoms and those demonstrating a lower systolic or diastolic blood pressure, renal impairment, or a restrictive left ventricular physiology on echocardiography. Interventions targeted at reducing depression warrant further study as a possible way to improve quality of life and/or outcome in patients with heart failure.
Key Words: Clinical depression • Survival • Non-ischaemic heart failure
Received May 18, 2001; Revised October 9, 2001; Accepted December 14, 2001
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  I. Lesman-Leegte, D. J. van Veldhuisen, H. L. Hillege, D. Moser, R. Sanderman, and T. Jaarsma Depressive symptoms and outcomes in patients with heart failure: data from the COACH study Eur J Heart Fail, December 1, 2009; 11(12): 1202 - 1207. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Parissis, D. Farmakis, M. Nikolaou, D. Birmpa, V. Bistola, I. Paraskevaidis, I. Ikonomidis, S. Gaitani, K. Venetsanou, G. Filippatos, et al. Plasma B-type natriuretic peptide and anti-inflammatory cytokine interleukin-10 levels predict adverse clinical outcome in chronic heart failure patients with depressive symptoms: a 1-year follow-up study Eur J Heart Fail, October 1, 2009; 11(10): 967 - 972. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Rafanelli, Y. Milaneschi, and R. Roncuzzi Minor Depression as a Short-Term Risk Factor in Outpatients With Congestive Heart Failure Psychosomatics, September 1, 2009; 50(5): 493 - 499. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Jaarsma, J. M. Beattie, M. Ryder, F. H. Rutten, T. McDonagh, P. Mohacsi, S. A. Murray, T. Grodzicki, I. Bergh, M. Metra, et al. Palliative care in heart failure: a position statement from the palliative care workshop of the Heart Failure Association of the European Society of Cardiology Eur J Heart Fail, May 1, 2009; 11(5): 433 - 443. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Rathore, Y. Wang, B. G. Druss, F. A. Masoudi, and H. M. Krumholz Mental Disorders, Quality of Care, and Outcomes Among Older Patients Hospitalized With Heart Failure: An Analysis of the National Heart Failure Project Arch Gen Psychiatry, December 1, 2008; 65(12): 1402 - 1408. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Ross, G. K. Mulvey, B. Stauffer, V. Patlolla, S. M. Bernheim, P. S. Keenan, and H. M. Krumholz Statistical Models and Patient Predictors of Readmission for Heart Failure: A Systematic Review Arch Intern Med, July 14, 2008; 168(13): 1371 - 1386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J T Parissis, M Nikolaou, D Farmakis, V Bistola, I A Paraskevaidis, S Adamopoulos, G Filippatos, and D T Kremastinos Clinical and prognostic implications of self-rating depression scales and plasma B-type natriuretic peptide in hospitalised patients with chronic heart failure Heart, May 1, 2008; 94(5): 585 - 589. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Thomas, D. W. Chapa, E. Friedmann, C. Durden, A. Ross, M. C. Y. Lee, and H.-J. Lee Depression in Patients With Heart Failure: Prevalence, Pathophysiological Mechanisms, and Treatment Crit. Care Nurse, April 1, 2008; 28(2): 40 - 55. [Full Text] [PDF]
|
|
|
|
|
|
H. Faller, S. Stork, M. Schowalter, T. Steinbuchel, V. Wollner, G. Ertl, and C. E. Angermann Depression and survival in chronic heart failure: Does gender play a role? Eur J Heart Fail, October 1, 2007; 9(10): 1018 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Andrei, R. Fraguas Jr., R. M.S. Telles, T. C.T.F. Alves, C. M.C. Strunz, A. Nussbacher, J. Rays, D. V. Iosifescu, and M. Wajngarten Major Depressive Disorder and Inflammatory Markers in Elderly Patients With Heart Failure Psychosomatics, August 1, 2007; 48(4): 319 - 324. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Rutledge, V. A. Reis, S. E. Linke, B. H. Greenberg, and P. J. Mills Depression in Heart Failure: A Meta-Analytic Review of Prevalence, Intervention Effects, and Associations With Clinical Outcomes J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1527 - 1537. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Lesman-Leegte, T. Jaarsma, R. Sanderman, G. Linssen, and D. J. van Veldhuisen Depressive symptoms are prominent among elderly hospitalised heart failure patients Eur J Heart Fail, October 1, 2006; 8(6): 634 - 640. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Altimir, J. Lupon, B. Gonzalez, M. Prats, T. Parajin, A. Urrutia, R. Coll, and V. Valle Sex and age differences in fragility in a heart failure population Eur J Heart Fail, August 1, 2005; 7(5): 798 - 802. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. W. Gold, M.-L. Wong, D. S. Goldstein, H. K. Gold, D. S. Ronsaville, M. Esler, S. Alesci, A. Masood, J. Licinio, T. D. Geracioti Jr., et al. Cardiac implications of increased arterial entry and reversible 24-h central and peripheral norepinephrine levels in melancholia PNAS, June 7, 2005; 102(23): 8303 - 8308. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. J. Molloy, D. W. Johnston, and M. D. Witham Family caregiving and congestive heart failure. Review and analysis Eur J Heart Fail, June 1, 2005; 7(4): 592 - 603. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. P. Davis, N. M. Albert, and J. B. Young Palliation of heart failure American Journal of Hospice and Palliative Medicine, May 1, 2005; 22(3): 211 - 222. [Abstract] [PDF]
|
|
|
|
 |
|
 J. K. Schulman, P. R. Muskin, and P. A. Shapiro Psychiatry and Cardiovascular Disease Focus, April 1, 2005; 3(2): 208 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Junger, D. Schellberg, T. Muller-Tasch, G. Raupp, C. Zugck, A. Haunstetter, S. Zipfel, W. Herzog, and M. Haass Depression increasingly predicts mortality in the course of congestive heart failure Eur J Heart Fail, March 2, 2005; 7(2): 261 - 267. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. O'Connor and K. E. Joynt Depression: are we ignoring an important comorbidity in heart failure? J. Am. Coll. Cardiol., May 5, 2004; 43(9): 1550 - 1552. [Full Text] [PDF]
|
|
|
|
|
|
S. Jacob, J. C. Sebastian, and G. Abraham Depression and congestive heart failure: are antidepressants underutilized? Eur J Heart Fail, June 1, 2003; 5(3): 399 - 400. [Full Text] [PDF]
|
|