Abstract 2426: The Impact of Depressive Symptoms on Survival in Patients with Heart Failure is Altered by Body Mass Index
Background: Depressive symptoms predict shorter event-free survival in patients with heart failure (HF). Increased body mass index (BMI) is associated with longer event-free survival in patients with HF. No investigators have explored whether there is an interaction between BMI and depressive symptoms on survival in patients with HF.
Purpose: To determine whether the effect of depressive symptoms on cardiac event-free survival differs among patients with normal vs. elevated BMI.
Methods: A total of 166 patients (64% male, 61±11 years, 61% NYHA class III/IV, median BMI 31 kg/m2) were recruited from an outpatient HF clinic. Depressive symptoms were measured by the Beck Depression Inventory-II (BDI). BMI was calculated by dieticians and 24 month event-free survival was determined by patient interview and medical record review. Survival curves were computed using the Kaplan-Meier method: groups compared using log rank test.
Results: Patients with depressive symptoms (BDI >13) had shorter event-free survival compared to patients without depressive symptoms (p= .05). In a Cox regression, higher BMI and fewer depressive symptoms predicted longer event-free survival after controlling for age, gender, and NYHA class (p< .01). When stratified by BMI, normal and overweight patients with depressive symptoms had shorter event-free survival than obese patients (p< .01) (Fig. 1⇓).
Conclusion: These findings suggest that event-free survival in normal and overweight patients is affected by depressive symptoms, while obese patients have better event-free survival regardless of depressive symptoms. This provides additional evidence for longer survival associated with obesity in HF.