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

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26 Scopus citations


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 languageEnglish
Pages (from-to)85-91
Number of pages7
JournalHeart and Lung: Journal of Acute and Critical Care
Issue number2
StatePublished - 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.


  • Antidepressants
  • Depressive symptoms
  • Heart failure
  • Mortality

ASJC Scopus subject areas

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


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