TY - JOUR
T1 - Depressive symptoms and outcomes in patients with heart failure
T2 - Data from the COACH study
AU - Lesman-Leegte, Ivonne
AU - Van Veldhuisen, Dirk J.
AU - Hillege, Hans L.
AU - Moser, Debra
AU - Sanderman, Robbert
AU - Jaarsma, Tiny
PY - 2009/12
Y1 - 2009/12
N2 - Aims To study the prognostic value of depressive symptoms on heart failure (HF) readmission and mortality, in a large and clinically relevant population of hospitalized HF patients adjusted for disease severity by B-type natriuretic peptide (BNP) level. Methods and results We studied 958 patients enrolled after hospitalization for HF; 37 female; mean age 71 ± 11 years; New York Heart Association class II (51) or III/IV (49). Left ventricular ejection fraction: 33 ± 14, and median BNP level: 454 pg/mL (75 CI, 195-876 pg/mL). In total, 377 patients (39) had depressive symptoms [Centre for Epidemiological Studies Depression Scale (CES-D) score ≥16] and 200 (21) had severe depressive symptoms (score ≥24). During 18 months of follow-up, 386 (40) patients reached the primary endpoint of death or readmission for HF. In multivariate analyses, CES-D was significantly associated with the primary endpoint [hazard ratio (HR) 1.13, P = 0.02], and also with both individual components of the primary endpoint [HF readmission (HR 1.165, P = 0.02) and mortality (HR 1.169, P = 0.02)]. Patients with severe depressive symptoms had a >40 higher risk for HF readmission or death. Conclusion In patients with HF, depression is independently associated with poor outcomes. These findings highlight the need for continued exploration of whether improvements in depression lead to better cardiovascular outcomes.The study was registered at clinical trial (www.trialregister.nl): NCT 98675639.
AB - Aims To study the prognostic value of depressive symptoms on heart failure (HF) readmission and mortality, in a large and clinically relevant population of hospitalized HF patients adjusted for disease severity by B-type natriuretic peptide (BNP) level. Methods and results We studied 958 patients enrolled after hospitalization for HF; 37 female; mean age 71 ± 11 years; New York Heart Association class II (51) or III/IV (49). Left ventricular ejection fraction: 33 ± 14, and median BNP level: 454 pg/mL (75 CI, 195-876 pg/mL). In total, 377 patients (39) had depressive symptoms [Centre for Epidemiological Studies Depression Scale (CES-D) score ≥16] and 200 (21) had severe depressive symptoms (score ≥24). During 18 months of follow-up, 386 (40) patients reached the primary endpoint of death or readmission for HF. In multivariate analyses, CES-D was significantly associated with the primary endpoint [hazard ratio (HR) 1.13, P = 0.02], and also with both individual components of the primary endpoint [HF readmission (HR 1.165, P = 0.02) and mortality (HR 1.169, P = 0.02)]. Patients with severe depressive symptoms had a >40 higher risk for HF readmission or death. Conclusion In patients with HF, depression is independently associated with poor outcomes. These findings highlight the need for continued exploration of whether improvements in depression lead to better cardiovascular outcomes.The study was registered at clinical trial (www.trialregister.nl): NCT 98675639.
KW - B-type natriuretic peptide
KW - Depressive symptoms
KW - Heart failure
KW - Prognosis
KW - Readmission
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U2 - 10.1093/eurjhf/hfp155
DO - 10.1093/eurjhf/hfp155
M3 - Article
C2 - 19926602
AN - SCOPUS:72949122813
SN - 1388-9842
VL - 11
SP - 1202
EP - 1207
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 12
ER -