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Cited by 55Cardiac Health and Mental HealthHeart Failure Treatment and ManagementCardiovascular Function and Risk Factors

Depression Worsens Outcomes in Elderly Patients with Heart Failure: An Analysis of 48,117 Patients in a Community Setting

Macchia, Alejandro, Monte, Simona, Pellegrini, Fabio, Romero, Marilena, D'Ettorre, Antonio, Tavazzi, Luigi, Tognoni, Gianni, Maggioni, Aldo P.·2008·European Journal of Heart Failure
DOI 10.1016/j.ejheart.2008.05.011
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Abstract

Aims: To assess the relationship between depression and clinical outcomes among elderly patients with heart failure (HF) in a community setting. Methods and results: To identify patients with HF and depression we used record linkage analysis of hospital discharge records, prescription databases and vital statistics. All consecutive patients aged ≥ 60 years in 6 Local Health Authorities in Italy were included. HF was defined as either: 1) hospital discharge with HF diagnosis (ICD-9: 428) and/or 2) chronic treatment for HF identified as concomitant (within 45days) prescription of any combination of ACE inhibitors, digoxin, furosemide, bisoprolol, carvedilol, spironolactone, ARB-blockers. Depression was identified from exposure to psychotropic drugs before HF diagnosis. Cox proportional hazards models adjusted for major confounders were used. To adjust for potential residual known confounders, a propensity score analysis was performed. Sensitivity and subgroup analysis were used to demonstrate the consistency or robustness of the results. 48,117 patients with HF were identified. Of these, 3328 (6.9%) were treated for depression. Among patients with HF, those with depression were significantly older, and more likely to be women with a previous stroke. Depression significantly worsened major outcomes including all cause mortality [HR (95%CI); 1.20 (1.08–1.33)] and the composite of stroke/TIA/AMI [1.23 (1.13–1.34)]. Patients with depression had no increased risk of rehospitalisation for HF. Propensity scores and subgroup analysis confirmed these findings. Conclusion: Among elderly patients with HF, depression was independently associated with poor clinical outcomes mostly due to an increase in vascular events.

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Authors
Macchia, A., Monte, S., Pellegrini, F., Romero, M., D'Ettorre, A., Tavazzi, L., Tognoni, G., & Maggioni, A. P.
Affiliations
  • Consorzio Mario Negri Sud, Santa Maria Imbaro , Chieti ,
  • Policlinico San Matteo Fondazione (IT)
  • Associazione Nazionale Medici Cardiologi Ospedalieri (IT)
Corresponding author
Maggioni, Aldo P.
ORCID
Venue
European Journal of Heart Failure
Publisher
Oxford University Press (OUP)
Published
2008-07-01
Volume
10
Issue
7
Pages
714-721
ISSN
  • 1388-9842 (ISSN-L)
  • 1879-0844
DOI
10.1016/j.ejheart.2008.05.011
OpenAlex
W1976132052
Cited by
55
References
42
Citations by year
2025: 1 · 2022: 3 · 2021: 1 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 4 · 2015: 5 · 2014: 2 · 2013: 4 · 2012: 9
FWCI
4.85
Type
journal article
Language
en
Open access
closed
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations
  • European Journal of Heart Failure (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
depression, heart failure, elderly patients, all-cause mortality, stroke, transient ischemic attack, myocardial infarction, hospital readmission, psychotropic drugs, comorbidities, community-dwelling patients
MeSH terms
Aged, Aged, 80 and over, Antidepressive Agents, Depression, Female, Heart Failure, Humans, Italy, Male, Middle Aged, Prognosis, Chi-Square Distribution, Proportional Hazards Models, Statistics, Nonparametric

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