Depressive symptoms and poor social support have a synergistic effect on event-free survival in patients with heart failure

Background: Depressive symptoms and poor social support are predictors of increased morbidity and mortality in patients with heart failure (HF). However, the combined contribution of depressive symptoms and social support event-free survival of patients with HF has not been examined. Objective: To compare event-free survival in 4 groups of patients with HF stratified by depressive symptoms and perceived social support (PSS). Method: A total of 220 patients completed the Beck Depression Inventory-II and the Multidimensional Perceived Social Support Scale and were followed for up to 4 years to collect data on death and hospitalizations. Results: Depressive symptoms (hazard ratio = 1.73, P = .008) and PSS (hazard ratio = 1.51, P = .048) were independent predictors of event-free survival. Depressed patients with low PSS had 2.1 times higher risk of events than non-depressed patients with high PSS (P = .003). Conclusion: Depressive symptoms and poor social support had a negative additive effect on event-free survival in patients with HF.