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OPERA-HF: Depression elevates mortality risk
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Researchers for the OPERA-HF study concluded that moderate-to-severe depression was an independent predictor of mortality in patients with HF.
Previous research showed a link between depression and mortality in patients with HF, but it was unclear whether the effect was independent of other risk factors for HF.
John Cleland
John Cleland, MD, and colleagues analyzed 154 patients hospitalized for HF and treated with loop diuretics. They assessed depression according to responses to the Hospital Anxiety and Depression Scale (HADS-D) questionnaire and comorbidities by the Charlson comorbidity index. The findings were presented at Heart Failure 2015.
Overall, 103 patients had a no-to-normal depression as indicated by HADS-D score, 27 had mild depression and 24 had moderate-to-severe depression.
During a mean follow-up of 302 days, 27 patients died. Results of a univariate Cox regression analysis indicated that moderate-to-severe depression was associated with increased risk for death (HR = 5.11; 95% CI, 2.39-10.93) compared with no-to-normal or mild depression. After controlling for sex, age, hypertension and N-terminal pro–B-type natriuretic peptide, moderate-to-severe depression remained predictive of mortality (HR = 6.5; 95% CI, 2.19-19.32) and remained so after controlling for Charlson comorbidity index (HR = 5.38; 95% CI, 1.84-15.67), according to the researchers.
A low HADS-D score (0 to 7) was associated with decreased risk for mortality (HR = 0.21; 95% CI, 0.09-0.46).
“Our results show that depression is strongly associated with death during the year following discharge from the hospital after an admission for exacerbation of [HF]; we expect that the link persists beyond 1 year,” Cleland, professor of cardiology at Imperial College London and the University of Hull, United Kingdom, said in a press release. “Recognition and management of depression may reduce mortality for patients with [HF]. More research is needed to find out what clinicians and patients themselves can do to manage depression. Better treatments for [HF], comorbidities as well as depression itself may be required.”
Immediate prescription of antidepressants is not recommended, according to Cleland, because previous research has indicated that they are not effective at reducing depression among those with HF.
“Clinicians should, however, screen patients with [HF] for depression and consider referring those affected for counseling,” he said. – by Erik Swain
Reference:
Sokoreli I, et al. Abstract P320. Presented at: Heart Failure 2015; May 23-26, 2015; Seville, Spain.
Disclosure: Cleland reports receiving research support from Philips Research.