Document Detail

Clinical depression is common and significantly associated with reduced survival in patients with non-ischaemic heart failure.
MedLine Citation:
PMID:  12167395     Owner:  NLM     Status:  MEDLINE    
Several studies have shown that depression is an important predictor of morbidity and mortality in patients with ischaemic heart failure. We have investigated whether clinically recognised depression is linked to mortality in patients with non-ischaemic heart failure due to dilated cardiomyopathy (DCM) in the Royal Brompton Hospital (RBH), a tertiary cardiac centre located in London, UK. We retrospectively examined a cohort of 396 consecutive adult patients with DCM who satisfied our inclusion and exclusion criteria identified from an echocardiographic database and the hospital medical records. Mean age was 53+/-15 years. In all, 83 patients (21%) were clinically depressed, the majority of which (60%) were taking antidepressant therapy. After a follow-up period of 48 months, 83 (21%) patients died, 15 (4%) underwent cardiac transplantation and 130 (33%) were readmitted; 29 (35%) of the deaths and 40 (31%) of the readmissions were among clinically depressed patients. After 5 years, clinically depressed patients had significantly higher mortality and readmission rates than non-depressed; 36 vs. 16% (hazards ratio for death, 3.0; 95% CI, 1.4-6.4; P=0.004), and 87 vs. 74% (hazards ratio for readmission, 0.25; 95% CI, 0.07-0.90; P=0.03), respectively. The risk of depression was greatly increased in the presence of other recognised adverse clinical variables at baseline. Depression increases the risk of death and readmission in patients with heart failure secondary to non-ischaemic DCM. The risk associated with depression appears to be greatest among patients with milder disease, those with a shorter duration of symptoms and those demonstrating a lower systolic or diastolic blood pressure, renal impairment, or a restrictive left ventricular physiology on echocardiography. Interventions targeted at reducing depression warrant further study as a possible way to improve quality of life and/or outcome in patients with heart failure.
R Faris; H Purcell; M Y Henein; A J S Coats
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of heart failure     Volume:  4     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-08     Completed Date:  2002-10-29     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  541-51     Citation Subset:  IM    
Department of Clinical Cardiology, Royal Brompton Hospital, London, UK.
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MeSH Terms
Cardiomyopathy, Dilated / diagnosis,  mortality,  psychology*
Depressive Disorder / diagnosis*,  mortality,  psychology
Heart Failure / diagnosis,  mortality,  psychology*
Middle Aged
Retrospective Studies
Survival Rate
Comment In:
Eur J Heart Fail. 2003 Jun;5(3):399-400   [PMID:  12798840 ]

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