Clinical InvestigationCongestive Heart FailureRelationship between depressive symptoms and long-term mortality in patients with heart failure
Section snippets
Subjects
The study was approved by the Duke University Health System Institutional Review Board and conducted at the Duke University Medical Center, Durham, NC. The study participants were recruited from the adult patients ≥18 years old who were admitted to the cardiology service at Duke University Medical Center between March 1997 and June 2003. Patients were eligible for enrollment if they had clinically diagnosed HF, defined as New York Heart Association (NYHA) class ≥II, an ejection fraction of ≤35%
Patient characteristics and follow-up information
The study population consisted of 1006 patients with HF. Approximately 34.6% of the participants were admitted because of HF exacerbation. The rest of the participants were admitted for other reasons, such as chest pain due to MI or unstable angina, arrhythmia, and so on (Table I). On average, the patients were 68 years old. Sixty-two percent were male and 73% were white. Heart failure was of ischemic etiology present in 62% of the participants, and 41% of the study population had had an MI
Discussion
In these patients with HF, self-rated measurement of depression defined by BDI scores ≥10 significantly predicted mortality an average of 2.66 ± 2.0 years after index hospitalization. Furthermore, the severity of the self-reported depressive symptoms showed a significant “dose-response” relationship with reduced survival. These negative associations emerged shortly after admission and persisted throughout the follow-up period. Using items of BDI assessing mood and anhedonia only has no
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Cited by (0)
The study was supported in part by National Institutes of Mental Health grants R01MH51191 and R01MH63211-Minority Supplement Award (WJ), and the APIRE/Merck & Co. Early Academic Career Research Award, 2004 (WJ).