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Worsening depressive symptoms are associated with adverse clinical outcomes in patients with heart failure.

Publication ,  Journal Article
Sherwood, A; Blumenthal, JA; Hinderliter, AL; Koch, GG; Adams, KF; Dupree, CS; Bensimhon, DR; Johnson, KS; Trivedi, R; Bowers, M; O'Connor, CM ...
Published in: J Am Coll Cardiol
January 25, 2011

OBJECTIVES: The purpose of this study was to assess the impact of changes in symptoms of depression over a 1-year period on subsequent clinical outcomes in heart failure (HF) patients. BACKGROUND: Emerging evidence shows that clinical depression, which is prevalent among patients with HF, is associated with a poor prognosis. However, it is uncertain how changes in depression symptoms over time may relate to clinical outcomes. METHODS: One-hundred forty-seven HF outpatients with ejection fraction of less than 40% were assessed for depressive symptoms using the Beck Depression Inventory (BDI) at baseline and again 1 year later. Cox proportional hazards regression analyses, controlling for established risk factors, were used to evaluate how changes in depressive symptoms were related to a combined primary end point of death or cardiovascular hospitalization over a median follow-up period of 5 years (with a range of 4 to 7 years and no losses to follow-up). RESULTS: The 1-year change in symptoms of depression, as indicated by higher BDI scores over a 1-year interval (1-point BDI change hazard ratio [HR]: 1.07, 95% confidence interval [CI]: 1.02 to 1.12, p = 0.007), was associated with death or cardiovascular hospitalization after controlling for baseline depression (baseline BDI HR: 1.1, 95% CI: 1.06 to 1.14, p < 0.001) and established risk factors, including HF cause, age, ejection fraction, plasma N-terminal pro-B-type natriuretic peptide level, and prior hospitalizations. CONCLUSIONS: Worsening symptoms of depression are associated with a poorer prognosis in HF patients. Routine assessment of symptoms of depression in HF patients may help to guide appropriate medical management of these patients who are at increased risk for adverse clinical outcomes.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

January 25, 2011

Volume

57

Issue

4

Start / End Page

418 / 423

Location

United States

Related Subject Headings

  • Survival Analysis
  • Sickness Impact Profile
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Regression Analysis
  • Psychiatric Status Rating Scales
  • Prospective Studies
  • Prognosis
  • Predictive Value of Tests
 

Citation

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Sherwood, A., Blumenthal, J. A., Hinderliter, A. L., Koch, G. G., Adams, K. F., Dupree, C. S., … O’Connor, C. M. (2011). Worsening depressive symptoms are associated with adverse clinical outcomes in patients with heart failure. J Am Coll Cardiol, 57(4), 418–423. https://doi.org/10.1016/j.jacc.2010.09.031
Sherwood, Andrew, James A. Blumenthal, Alan L. Hinderliter, Gary G. Koch, Kirkwood F. Adams, Carla Sueta Dupree, Daniel R. Bensimhon, et al. “Worsening depressive symptoms are associated with adverse clinical outcomes in patients with heart failure.J Am Coll Cardiol 57, no. 4 (January 25, 2011): 418–23. https://doi.org/10.1016/j.jacc.2010.09.031.
Sherwood A, Blumenthal JA, Hinderliter AL, Koch GG, Adams KF, Dupree CS, et al. Worsening depressive symptoms are associated with adverse clinical outcomes in patients with heart failure. J Am Coll Cardiol. 2011 Jan 25;57(4):418–23.
Sherwood, Andrew, et al. “Worsening depressive symptoms are associated with adverse clinical outcomes in patients with heart failure.J Am Coll Cardiol, vol. 57, no. 4, Jan. 2011, pp. 418–23. Pubmed, doi:10.1016/j.jacc.2010.09.031.
Sherwood A, Blumenthal JA, Hinderliter AL, Koch GG, Adams KF, Dupree CS, Bensimhon DR, Johnson KS, Trivedi R, Bowers M, Christenson RH, O’Connor CM. Worsening depressive symptoms are associated with adverse clinical outcomes in patients with heart failure. J Am Coll Cardiol. 2011 Jan 25;57(4):418–423.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

January 25, 2011

Volume

57

Issue

4

Start / End Page

418 / 423

Location

United States

Related Subject Headings

  • Survival Analysis
  • Sickness Impact Profile
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Regression Analysis
  • Psychiatric Status Rating Scales
  • Prospective Studies
  • Prognosis
  • Predictive Value of Tests