Relationship of depressive symptoms with hospitalization and death in Japanese patients with heart failure.
BACKGROUND
Depressive symptoms are risk factors for poor outcomes and are positively associated with disease severity in patients with heart failure (HF). However, little is known about this association in the Japanese population. Therefore, we evaluated the prevalence of depressive symptoms and whether depressive symptoms predicted hospitalization for HF and death independent of disease severity and other factors in HF patients.


RESULTS
A 2-year prospective cohort study was conducted on 115 outpatients with HF (73.9% males; mean age 64.7 years) in Tokyo. Of these, 27 patients (23.5%) were classified as having depressive symptoms (Center for Epidemiologic Studies Depression Scale score >or=16). Patients with depressive symptoms had higher rates of 2-year cardiac death or HF hospitalization (34.0% vs. 10.3%; P < .01), HF hospitalization (27.4% vs. 9.2%; P = .01), and all-cause death (27.4% vs. 7.2%; P < .01). Multivariate Cox regression analyses indicated that depressive symptoms were predictors of cardiac death or HF hospitalization (hazard ratio [HR], 3.29; P = .02), HF hospitalization (HR, 3.36; P = .04), and all-cause death (HR, 5.52; P = .01), independent of age and brain natriuretic peptide.


CONCLUSIONS
Depressive symptoms were common and independent predictors of poor outcomes in Japanese patients with HF.
Kato
Naoko
N
Department of Adult Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. naokat-tky@umin.ac.jp
Kinugawa
Koichiro
K
Yao
Atsushi
A
Hatano
Masaru
M
Shiga
Taro
T
Kazuma
Keiko
K
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000401:mortality* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000523:psychology*; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014041:Tokyo