title: Antidepressants do not improve event-free survival in patients with heart failure when depressive symptoms remain.
abstract: OBJECTIVE
  The purpose of this secondary data analysis was to compare event-free survival among four groups of patients with heart failure (HF) that were stratified by presence of depressive symptoms and antidepressants.
  
  
  METHODS
  We analyzed data from 209 outpatients (30.6% female, 62 ± 12 years, 54% NYHA Class III/IV) enrolled in a multicenter HF registry who had data on depressive symptoms, antidepressant use, and cardiac rehospitalization and death outcomes during 1 year follow up. Depressive symptoms were assessed using the Patient Health Questionnaire-9.
  
  
  RESULTS
  Depressive symptoms, not antidepressant therapy, predicted event-free survival (HR = 2.4, 95% CI = 1.2-4.6, p = .009). Depressed patients without antidepressants had 4.1 times higher risk of death and hospitalization than non-depressed patients on antidepressant (95% CI = 1.2-13.9, p = .022) after controlling for age, gender, NYHA class, body mass index, diabetes, medication of ACEI and beta-blockers.
  
  
  CONCLUSIONS
  Antidepressant use was not a predictor of event-free survival outcomes when patients still reported depressive symptoms. Ongoing assessment of patients on antidepressants is needed to assure adequate treatment.
authors.affiliation: RICH Heart Program, University of Kentucky College of Nursing, Lexington, KY 40536-0232, USA. misook.chung@uky.edu
authors.forename: Misook L
authors.initials: ML
authors.lastname: Chung
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Dekker
authors.forename: Terry A
authors.initials: TA
authors.lastname: Lennie
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010043:Outcome and Process Assessment, Health Care; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents