Abstract 2054: Impact of Depression on Mortality in Ischemic Cardiomyopathy
Background: Numerous studies have indicated the adverse prognostic impact of depression particularly in patients with coronary heart disease, but limited information is available on its impact in patients with ischemic cardiomyopathy.
Methods: We evaluated 522 consecutive patients following formal cardiac rehabilitation and compared a subgroup of 75 patients (65±12 years; 27% female) with ejection fraction (EF) d40% (mean 29.5±8.3%) compared with 420 patients (64±10 years; 27% female) with EF e50% to determine the impact of depression, assessed by validated questionnaire, on total mortality during 3.5 year follow-up.
Results: Prevalence of depression following cardiac rehabilitation was 9% and 6%, respectively in patients with ischemic cardiomyopathy and those with preserved EF. In both groups of patients, those with depressive symptoms had higher mortality compared to those without depressive symptoms (mortality 50% vs. 16%, p= 0.04 and 13% vs. 3%, p= 0.02 for ischemic cardiomyopathy and normal EF, respectively). In multivariate analysis, independent predictors of mortality included peak oxygen consumption (chi-square 14, p = 0.0002), age (chi-square 9, p = 0.002), EF (chi-square 7.1, p = 0.008), and depression (chi-square 5.7, p = 0.02).
Conclusions: Depressive symptoms strongly predict mortality in both patients with ischemic cardiomyopathy and preserved EF. In fact, symptoms of depression predicted mortality nearly as strongly as EF. Greater attention towards assessment and treatment of depression in patients with ischemic cardiomyopathy is needed to improve overall survival.