Abstract 11426: Signs of Depression Predict Mortality Among Swedish Heart Failure Patients

Abstract

Introduction: Anxiety and depression are common comorbid conditions in heart failure (HF), and there is growing evidence that they increase the risk of adverse outcomes, including rehospitalization and functional decline. Hypothesis: We aimed to determine if symptoms of anxiety and depression would predict mortality and rehospitalization in a Swedish prospective HF patient cohort. Methods: 387 patients hospitalized for HF (mean age 75 years; 32% women) were assessed using the Hospital Anxiety and Depression Scale (HADS) to measure symptoms of anxiety (HADS Anxiety) and depression (HADS Depression). The median follow-up time to death and rehospitalization was 665 (range,1737; interquartile range, 811) and 316 (range, 2069; interquartile range, 348) days, respectively. Relations between baseline HADS scores, mortality and rehospitalization risk were analyzed using multivariable Cox regression analysis adjusted for age, sex, body- mass index, smoking, prevalent atrial fibrillation, educational level, prevalent diabetes, NYHA-class at hospitalization and systolic blood pressure. Results: A total of 30 patients (8%) had signs of depression according to HADS Depression score >11 points. In the fully adjusted Cox regression model using continuous standardized values per 1 SD change, higher score on HADS Depression scale (HR,1.42; CI, 1.16-1.75; p=0.001) yielded significant associations with increased mortality whereas no associations were found for HADS Anxiety scale (HR, 1.04; CI, 0.86-1.26; p=0.719). Rehospitalization risk (n = 246; 64%) was not significantly associated with higher scores on HADS Depression scale (HR, 1.08; CI, 0.94-1.25; p=0.274) or HADS Anxiety scale (HR, 0.95; CI, 0.82-1.09; p=0.449). Conclusions: Higher scores on HADS Depression scale indicated increased mortality risk in hospitalized HF patients, independently of traditional risk factors. However, higher scores on HADS Anxiety scale did not herald increased risk of mortality or rehospitalization.