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Heart Lung. 2013 Mar-Apr;42(2):85-91. doi: 10.1016/j.hrtlng.2012.12.003. Epub 2013 Jan 7.

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

Author information

1
RICH Heart Program, University of Kentucky College of Nursing, Lexington, KY 40536-0232, USA. misook.chung@uky.edu

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.

PMID:
23306168
PMCID:
PMC3594142
DOI:
10.1016/j.hrtlng.2012.12.003
[Indexed for MEDLINE]
Free PMC Article

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