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Relationship of depression to death or hospitalization in patients with heart failure.

Publication ,  Journal Article
Sherwood, A; Blumenthal, JA; Trivedi, R; Johnson, KS; O'Connor, CM; Adams, KF; Dupree, CS; Waugh, RA; Bensimhon, DR; Gaulden, L; Koch, GG ...
Published in: Arch Intern Med
February 26, 2007

BACKGROUND: Depression is widely recognized as a risk factor in patients with coronary heart disease. However, patients with heart failure (HF) have been less frequently studied, and the effect of depression on prognosis, independent of disease severity, is uncertain. METHODS: Two hundred four outpatients having a diagnosis of HF, with a ventricular ejection fraction of 40% or less, underwent baseline assessments including evaluation of depressive symptoms using the Beck Depression Inventory and of HF severity determined by plasma N-terminal pro-B-type natriuretic peptide. Cox proportional hazards regression analyses were used to examine the effects of depressive symptoms on a combined primary end point of death and hospitalizations because of cardiovascular disease (hereafter referred to as cardiovascular hospitalization) during a median follow-up of 3 years. RESULTS: Symptoms of depression (Beck Depression Inventory score) were associated with risk of death or cardiovascular hospitalization (P<.001) after controlling for established risk factors including HF disease severity, ejection fraction, HF etiology, age, and medications. Clinically significant symptoms of depression (Beck Depression Inventory score >/=10) were associated with a hazard ratio of 1.56 (95% confidence interval, 1.07-2.29) for the combined end point of death or cardiovascular hospitalization. Contrary to our expectation, antidepressant medication use was associated with increased likelihood of death or cardiovascular hospitalization (hazard ratio, 1.75; 95% confidence interval,1.14-2.68, P =.01) after controlling for severity of depressive symptoms and for established risk factors. CONCLUSIONS: Symptoms of depression were associated with an adverse prognosis in patients with HF after controlling for HF severity. The unexpected association of antidepressant medications with worse clinical outcome suggests that patients with HF requiring an antidepressant medication may need to be monitored more closely.

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Published In

Arch Intern Med

DOI

ISSN

0003-9926

Publication Date

February 26, 2007

Volume

167

Issue

4

Start / End Page

367 / 373

Location

United States

Related Subject Headings

  • Risk Factors
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Patient Compliance
  • North Carolina
  • Middle Aged
  • Male
  • Incidence
  • Humans
 

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Sherwood, A., Blumenthal, J. A., Trivedi, R., Johnson, K. S., O’Connor, C. M., Adams, K. F., … Hinderliter, A. L. (2007). Relationship of depression to death or hospitalization in patients with heart failure. Arch Intern Med, 167(4), 367–373. https://doi.org/10.1001/archinte.167.4.367
Sherwood, Andrew, James A. Blumenthal, Ranak Trivedi, Kristy S. Johnson, Christopher M. O’Connor, Kirkwood F. Adams, Carla Sueta Dupree, et al. “Relationship of depression to death or hospitalization in patients with heart failure.Arch Intern Med 167, no. 4 (February 26, 2007): 367–73. https://doi.org/10.1001/archinte.167.4.367.
Sherwood A, Blumenthal JA, Trivedi R, Johnson KS, O’Connor CM, Adams KF, et al. Relationship of depression to death or hospitalization in patients with heart failure. Arch Intern Med. 2007 Feb 26;167(4):367–73.
Sherwood, Andrew, et al. “Relationship of depression to death or hospitalization in patients with heart failure.Arch Intern Med, vol. 167, no. 4, Feb. 2007, pp. 367–73. Pubmed, doi:10.1001/archinte.167.4.367.
Sherwood A, Blumenthal JA, Trivedi R, Johnson KS, O’Connor CM, Adams KF, Dupree CS, Waugh RA, Bensimhon DR, Gaulden L, Christenson RH, Koch GG, Hinderliter AL. Relationship of depression to death or hospitalization in patients with heart failure. Arch Intern Med. 2007 Feb 26;167(4):367–373.

Published In

Arch Intern Med

DOI

ISSN

0003-9926

Publication Date

February 26, 2007

Volume

167

Issue

4

Start / End Page

367 / 373

Location

United States

Related Subject Headings

  • Risk Factors
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Patient Compliance
  • North Carolina
  • Middle Aged
  • Male
  • Incidence
  • Humans