Abstract 5637: Depressive Symptoms and Poor Social Support Have a Synergistic Effect on Event-Free Survival in Patients with Heart Failure.
Depressive symptoms are a predictor of increased morbidity and mortality in patients with heart failure (HF). Positive social support may have a buffering effect on depressive symptoms. However, the impact of social support on morbidity and mortality in the context of depressive symptoms in HF is unknown. To determine the impact of social support on event-free survival in patients with HF in the context of depressive symptoms. A total of 220 HF patients (66% male, age 61±11 yrs) completed the Perceived Social Support Scale (PSSS) and the Beck Depression Inventory-II (BDI-II) and were followed for up to 3 years to collect data on death, hospitalizations, and emergency room visits. Patients were grouped into 4 groups using a standard cut-point of 13 on the BDI-II and a median score 73 of the PSSS (Figure⇓). Cox regression was used to compare event-free survival among groups while controlling for age, gender, NYHA class, and functional status (Duke Activity Status Index). One third (32%) of patients had depressive symptoms. Depressed patients with low perceived social support (PSS) experienced shorter event-free survival than non-depressed patients with high PSS (p = .026; Figure⇓). Depressed patients with low PSS were at 1.8 times higher risk of events than non-depressed patients with high PSS while controlling for age, gender, NYHA class, and functional status (CI= 1.03 – 3.19; p= .04). Depressive symptoms and poor social support had a synergistic, negative effect on event-free survival in patients with HF. Interventions to improve clinical outcomes should address both social support networks and depressive symptoms.