Antidepressants do not improve event-free survival in patients with heart failure when depressive symptoms remain

Misook L. Chung; Rebecca L. Dekker; Terry A. Lennie; Debra K. Moser

doi:10.1016/j.hrtlng.2012.12.003

Antidepressants do not improve event-free survival in patients with heart failure when depressive symptoms remain

Misook L. Chung, Rebecca L. Dekker, Terry A. Lennie, Debra K. Moser

College of Nursing

Research output: Contribution to journal › Article › peer-review

27 Scopus citations

Abstract

Objective: The purpose of this secondary data analysis was to compare event-free survival among four groups of patients with heart failure (HF) that were stratified by presence of depressive symptoms and antidepressants. Methods: We analyzed data from 209 outpatients (30.6% female, 62 ± 12 years, 54% NYHA Class III/IV) enrolled in a multicenter HF registry who had data on depressive symptoms, antidepressant use, and cardiac rehospitalization and death outcomes during 1 year follow up. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Results: Depressive symptoms, not antidepressant therapy, predicted event-free survival (HR = 2.4, 95% CI = 1.2-4.6, p = .009). Depressed patients without antidepressants had 4.1 times higher risk of death and hospitalization than non-depressed patients on antidepressant (95% CI = 1.2-13.9, p = .022) after controlling for age, gender, NYHA class, body mass index, diabetes, medication of ACEI and beta-blockers. Conclusion: Antidepressant use was not a predictor of event-free survival outcomes when patients still reported depressive symptoms. Ongoing assessment of patients on antidepressants is needed to assure adequate treatment.

Original language	English
Pages (from-to)	85-91
Number of pages	7
Journal	Heart and Lung: Journal of Acute and Critical Care
Volume	42
Issue number	2
DOIs	https://doi.org/10.1016/j.hrtlng.2012.12.003
State	Published - Mar 2013

Bibliographical note

Funding Information:
This research was funded by the National Institutes of Health, National Institute of Nursing Research R01 NR 008567 , R01 NR 009280 , NINR P20 NR010679 , and NIH M01 RR02602 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.

Keywords

Antidepressants
Depressive symptoms
Heart failure
Mortality

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.hrtlng.2012.12.003

Cite this

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title = "Antidepressants do not improve event-free survival in patients with heart failure when depressive symptoms remain",

abstract = "Objective: The purpose of this secondary data analysis was to compare event-free survival among four groups of patients with heart failure (HF) that were stratified by presence of depressive symptoms and antidepressants. Methods: We analyzed data from 209 outpatients (30.6% female, 62 ± 12 years, 54% NYHA Class III/IV) enrolled in a multicenter HF registry who had data on depressive symptoms, antidepressant use, and cardiac rehospitalization and death outcomes during 1 year follow up. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Results: Depressive symptoms, not antidepressant therapy, predicted event-free survival (HR = 2.4, 95% CI = 1.2-4.6, p = .009). Depressed patients without antidepressants had 4.1 times higher risk of death and hospitalization than non-depressed patients on antidepressant (95% CI = 1.2-13.9, p = .022) after controlling for age, gender, NYHA class, body mass index, diabetes, medication of ACEI and beta-blockers. Conclusion: Antidepressant use was not a predictor of event-free survival outcomes when patients still reported depressive symptoms. Ongoing assessment of patients on antidepressants is needed to assure adequate treatment.",

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author = "Chung, {Misook L.} and Dekker, {Rebecca L.} and Lennie, {Terry A.} and Moser, {Debra K.}",

note = "Funding Information: This research was funded by the National Institutes of Health, National Institute of Nursing Research R01 NR 008567 , R01 NR 009280 , NINR P20 NR010679 , and NIH M01 RR02602 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.",

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AU - Dekker, Rebecca L.

AU - Lennie, Terry A.

AU - Moser, Debra K.

N1 - Funding Information: This research was funded by the National Institutes of Health, National Institute of Nursing Research R01 NR 008567 , R01 NR 009280 , NINR P20 NR010679 , and NIH M01 RR02602 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.

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N2 - Objective: The purpose of this secondary data analysis was to compare event-free survival among four groups of patients with heart failure (HF) that were stratified by presence of depressive symptoms and antidepressants. Methods: We analyzed data from 209 outpatients (30.6% female, 62 ± 12 years, 54% NYHA Class III/IV) enrolled in a multicenter HF registry who had data on depressive symptoms, antidepressant use, and cardiac rehospitalization and death outcomes during 1 year follow up. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Results: Depressive symptoms, not antidepressant therapy, predicted event-free survival (HR = 2.4, 95% CI = 1.2-4.6, p = .009). Depressed patients without antidepressants had 4.1 times higher risk of death and hospitalization than non-depressed patients on antidepressant (95% CI = 1.2-13.9, p = .022) after controlling for age, gender, NYHA class, body mass index, diabetes, medication of ACEI and beta-blockers. Conclusion: Antidepressant use was not a predictor of event-free survival outcomes when patients still reported depressive symptoms. Ongoing assessment of patients on antidepressants is needed to assure adequate treatment.

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KW - Mortality

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Antidepressants do not improve event-free survival in patients with heart failure when depressive symptoms remain

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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