J Psychosom Res. 2017 Mar;94:82-89. doi: 10.1016/j.jpsychores.2017.01.010. Epub 2017 Jan 24.
Depression increases the risk of mortality in patients with heart failure: A meta-analysis.
Journal of psychosomatic research
Emily C Gathright, Carly M Goldstein, Richard A Josephson, Joel W Hughes
Affiliations
Affiliations
- Department of Psychological Sciences, Kent State University, Kent, OH 44240, USA; Alpert Medical School, Brown University, Providence, RI 02903, USA. Electronic address: [email protected].
- Alpert Medical School, Brown University, Providence, RI 02903, USA.
- Harrington Heart & Vascular Institute, University Hospitals, Cleveland, OH 44106, USA; Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
- Department of Psychological Sciences, Kent State University, Kent, OH 44240, USA.
PMID: 28183407
PMCID: PMC5370194 DOI: 10.1016/j.jpsychores.2017.01.010
Abstract
BACKGROUND: Depression is a risk factor for mortality in cardiovascular diseases. Prior studies confirm that depression predicts adverse outcomes in patients with heart failure (HF). However, data were inconclusive regarding the effect of depression on mortality. This meta-analysis examines the relationship between depression and mortality in HF.
METHODS: Prospective studies of depression and mortality in HF published between 1999 and April 2016 were located using PubMed, PsychINFO, and MEDLINE. Comprehensive Meta-Analysis software was used to compute an aggregated effect size estimates of hazard ratios and to conduct subgroup analyses.
RESULTS: Eighteen studies met inclusion criteria. For 8 aggregated univariate and 14 multivariate estimates, depressive symptoms were related to all-cause mortality. A pooled HR of 3 multivariate analyses indicated that depressive symptoms were not linked to cardiovascular mortality. In subgroup analyses, depression predicted all-cause mortality in samples with a mean age >65. The impact of depression on all-cause mortality also differed by follow-up duration, with samples with shorter follow-up durations demonstrating a larger effect.
CONCLUSIONS: In HF, depression is related to increased all-cause mortality risk, with stronger effects in samples with shorter follow-up and in older adults. In older adults, depression may serve as a marker of more severe HF. However, this possibility is difficult to examine given inconsistent adjustment for HF severity. Additional studies may assist in determining the relationship between depression and cardiovascular mortality, as the low number of studies examining cardiovascular mortality may have precluded detection of an effect.
Copyright © 2017 Elsevier Inc. All rights reserved.
Keywords: Depression; Heart failure; Meta-analysis; Mortality
References
- J Clin Psychiatry. 2009 Dec;70(12):1667-73 - PubMed
- Brain Behav Immun. 2016 Oct;57:144-50 - PubMed
- Stat Med. 2002 Jun 15;21(11):1539-58 - PubMed
- Med Care. 2004 Jun;42(6):512-21 - PubMed
- Int J Cardiol. 2013 Aug 20;167(4):1217-25 - PubMed
- Biometrics. 1994 Dec;50(4):1088-101 - PubMed
- Am Heart J. 2007 Jul;154(1):102-8 - PubMed
- J Card Fail. 2012 Mar;18(3):238-45 - PubMed
- Eur J Heart Fail. 2007 Oct;9(10):1018-23 - PubMed
- Circ Heart Fail. 2013 May;6(3):387-94 - PubMed
- Eur J Clin Invest. 2011 Dec;41(12):1310-7 - PubMed
- Circulation. 2014 Jan 21;129(3):e28-e292 - PubMed
- JACC Heart Fail. 2015 Jul;3(7):542-50 - PubMed
- Eur J Heart Fail. 2005 Mar 2;7(2):261-7 - PubMed
- J Am Coll Cardiol. 2004 May 5;43(9):1542-9 - PubMed
- BMJ. 2003 Sep 6;327(7414):557-60 - PubMed
- J Card Fail. 2009 Dec;15(10):912-9 - PubMed
- Am Heart J. 2010 Feb;159(2):231-7 - PubMed
- J Clin Epidemiol. 2000 Nov;53(11):1119-29 - PubMed
- JAMA. 2004 Jul 21;292(3):344-50 - PubMed
- Ann Intern Med. 2009 Aug 18;151(4):W65-94 - PubMed
- Arch Intern Med. 2002 Sep 9;162(16):1860-6 - PubMed
- J Am Coll Cardiol. 2006 Oct 17;48(8):1527-37 - PubMed
- Natl Vital Stat Rep. 2013 May 8;61(4):1-117 - PubMed
- J Behav Med. 2011 Feb;34(1):13-22 - PubMed
- Circ Heart Fail. 2013 May;6(3):606-19 - PubMed
- Arch Intern Med. 2007 Feb 26;167(4):367-73 - PubMed
- Pain. 2000 Apr;85(3):415-24 - PubMed
- Int J Psychiatry Med. 1999;29(3):311-26 - PubMed
- Arch Intern Med. 2001 Aug 13-27;161(15):1849-56 - PubMed
- Am J Cardiol. 2011 Mar 1;107(5):723-9 - PubMed
- Gen Hosp Psychiatry. 2011 May-Jun;33(3):203-16 - PubMed
- BMJ. 1997 Sep 13;315(7109):629-34 - PubMed
- N Engl J Med. 2002 Oct 31;347(18):1397-402 - PubMed
- Psychosomatics. 2012 Jul-Aug;53(4):339-46 - PubMed
- Am J Cardiol. 2004 Dec 15;94(12):1577-80 - PubMed
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