Abstract P549: The Impact Of Neighborhood Factors On Mortality Among Depressed Patients With Systolic Heart Failure.

Abstract

Introduction: Neighborhood factors have been associated with risk factors for cardiovascular disease.. Among These neighborhood factors also impact physical functioning and access to resources. In individuals with heart failure (HF), who require a significant access to care and physical activity, these neighborhood factors may impact mortality. Data are limited evaluating the association of neighborhood and mortality in HF. Hypothesis: We hypothesized that better walk scores and less deprivation would be associated with a lower mortality in individuals with systolic HF. Methods: We screened hospitalized patients with systolic HF (EF≤45%) and NYHA class II-IV symptoms for depression at 8 Pittsburgh-area hospitals as part of the Hopeful Heart Study (R01 HL114016) and included patients who screened positive for depression and remained depressed when re-contacted by telephone 2 weeks after discharge. We classified neighborhoods using the validated Walk Score®and Area Deprivation Index for each patient’s address at study entry (both 0-100 scales), and assessed all-cause and cardiovascular mortality over a 12 month period post-enrollment. Mortality (top quartile vs. all others) was compared between ADI and Walk Score groups with adjustment for clinical covariates using Kaplan Meier survival analysis. Results: Final analysis included 629 depressed patients with systolic HF (43 % female, 75 % white, 86% HTN, 52% DM). There was no significant difference In mortality when comparing individuals in the top quartile of Walk Score (p = 0.381) or ADI (p = 0.379) to all others (Figure 1). Conclusions: Among depressed patients with systolic HF, there was no significant association between neighborhood factors including Walk Score or ADI and mortality. Further research is warranted to determine how neighborhood factors adversely impact individual with co-morbid depression and systolic HF. Further analyses are ongoing to determine if individual components of the Walk Score and ADI contribute to differences in mortality.