Abstract 2729: Depressive Symptom Is A Mediator Of The Link Between Trait Anxiety And Event-free Survival In Patients With Heart Failure
Background. Anxiety and depressive symptoms are prevalent among heart failure (HF) patients. The impact of anxiety on event-free survival remains unclear, whereas depressive symptoms predict event-free survival. Few have examined whether depressive symptoms mediate the association between anxiety and event-free survival.
Purpose. To determine whether depressive symptoms mediate the link between trait anxiety (trait-A) and event-free survival.
Methods. A total of 260 HF patients (63 ± 14 years, 56% male, 48% NYHA class III/IV) were recruited during an index hospitalization for HF. Trait-A and depressive symptoms were measured by Spielberger’s Trait Anxiety Inventory and the Beck Depression Inventory, respectively. Event-free survival (emergency department visit, hospitalization, and death) was collected for 6-month follow-up and confirmed by review of hospital records. Hierarchical Cox proportional hazards regression and mediation analysis were used to test mediator effct of depressive symptoms.
Results. Trait-A (HR = 1.02, 95% CI = 1.00 –1.04) and depressive symptoms (HR = 1.05, 95% CI = 1.03–1.07) independently predicted event-free survival, after controlling age, gender, body mass index, NYHA class, EF, and comorbidities. Depressive symptoms were associated with trait-A in hierarchical multiple regression (p<.001). Mediation analysis indicated depressive symptoms mediated the impact of trait-A on event-free survival.
Conclusions. The effect of trait-A on event-free survival is mediated by depressive symptoms. Interventions to reduce depressive symptoms may improve event-free survival by their impact on both depressive symptoms and trait-A.