Major depression and clinical outcomes in patients with heart failure with preserved ejection fraction.
Aged
Aged, 80 and over
Antidepressive Agents
/ therapeutic use
Cardiovascular Diseases
/ mortality
Cause of Death
Depressive Disorder, Major
/ complications
Female
Heart Failure
/ complications
Hospitalization
/ statistics & numerical data
Humans
Male
Middle Aged
Mortality
Patient Health Questionnaire
Prognosis
Proportional Hazards Models
Stroke Volume
HFpEF outcome
antidepressants
depression
heart failure
Journal
European journal of clinical investigation
ISSN: 1365-2362
Titre abrégé: Eur J Clin Invest
Pays: England
ID NLM: 0245331
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
23
07
2020
revised:
03
09
2020
accepted:
03
09
2020
pubmed:
11
9
2020
medline:
30
11
2021
entrez:
10
9
2020
Statut:
ppublish
Résumé
Limited data have been published concerning about depression in heart failure with preserved ejection fraction (HFpEF). Besides, among HFpEF patients with depression, the efficacy of antidepressants is poorly defined. Therefore, our current study was aimed to examine the relationship between major depression and clinical outcomes in HFpEF patients and further address the effects of antidepressants on prognosis in patients with major depression and HFpEF. A total of 1431 patients enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial (TOPCAT) were divided into 2 groups according to the baseline depression status. Major depression was diagnosed if the Patient Health Questionnaire-9 score (PHQ-9) ≥ 10. Univariable and multivariable Cox proportional hazards models tested the association of major depression with outcomes and the effects of antidepressants among HFpEF patients with major depression during a follow-up of 6 years. 26.7% (382/1431) of patients were diagnosed with major depression. After multivariable adjustment, major depression at baseline was not significantly associated with cardiovascular outcomes (fully adjusted hazard ratio (aHR) 0.95 [0.76-1.18] for primary outcomes; aHR: 0.86 [0.67-1.10] for HF hospitalization; aHR: 1.06 [0.91-1.23] for any hospitalization; aHR: 1.00 [0.70-1.43] for cardiovascular death; aHR: 1.24 [0.96-1.61] for all-cause death). Additionally, among HFpEF patients with major depression, the use of antidepressants was not associated with adverse events (P > .05 for all analyses). In HFpEF patients, major depression at baseline did not increase mortality or rehospitalization. Additionally, treatment with antidepressants might not improve prognosis among HFpEF patients with major depression. Future studies are warranted to explore the effects of antidepressants on HFpEF patients with depression.
Substances chimiques
Antidepressive Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13401Subventions
Organisme : National Natural Science Foundation of China
ID : 81770392
Organisme : National Natural Science Foundation of China
ID : 81770394
Organisme : National Natural Science Foundation of China
ID : 81700344
Organisme : National Natural Science Foundation of China
ID : 81800344
Organisme : National Natural Science Foundation of China
ID : 81800345
Organisme : Science and Technology Program Foundation of Guangzhou
ID : 201707010124
Organisme : Guangdong Natural Science Foundation
ID : 2017A030310311
Organisme : Guangdong Natural Science Foundation
ID : 2017A030313795
Organisme : Young Teachers' Basic Scientific Research Business Expenses Project
ID : 20ykpy72
Organisme : Medical Research Foundation of Guangdong Province
ID : A2017030
Organisme : Medical Research Foundation of Guangdong Province
ID : A2018107
Organisme : Medical Research Foundation of Guangdong Province
ID : A2018082
Organisme : China Postdoctoral Science Foundation
ID : 2019M663312
Organisme : China Postdoctoral Science Foundation
ID : 2019TQ0380
Organisme : China Postdoctoral Science Foundation
ID : 2019M660229
Informations de copyright
© 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
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