Abstract 11405: The Association of Co-Morbid Symptoms of Depression and Anxiety With All-Cause Mortality in Patients With Heart Failure
Introduction: Depression or anxiety are associated with survival in heart failure (HF); however, whether co-morbid symptoms of anxiety and depression are associated with survival in patients with HF is unknown.
Hypothesis: Co-morbid symptoms of depression and anxiety are more strongly associated with all-cause mortality in patients with HF compared to those with anxiety or depression alone.
Methods: A total of 1,260 HF patients participated and were followed for mortality outcomes for 12 months. The Patient Health Questionnaire (PHQ-9) and Brief Symptom Inventory-anxiety subscale (BSI) were used to measure symptoms of depression and anxiety. Cox regression analysis was used to determine whether co-morbid symptoms of depression and anxiety independently predicted all-cause mortality controlling for age,gender, ethnicity, and NYHA class. Depression and anxiety were treated first as continuous level variables, then as categorical variables using standard published cut points. Patients were divided into four groups based on the presence of anxiety and depression symptoms: 1) neither anxiety nor depression, 2) depression alone, 3) anxiety alone, and 4) co-morbid depression and anxiety
Results: When entered as continuous variables, the interaction between anxiety and depression (HR 1.02; 95% CI: 1.01-1.03; p = 0.002) was a significant predictor of all-cause mortality. When entered as a categorical variable, co-morbid symptoms of depression and anxiety (versus the other three groups) independently predicted all-cause mortality (HR 2.59; 95% CI: 1.49-4.49; p = 0.001).
Conclusions: To improve mortality outcomes in patient with HF, attention must be paid by healthcare providers to the assessment and management of co-morbid symptoms of depression and anxiety.
Author Disclosures: A. Alhurani: None. R. Dekker: None. M. Abed: None. A. Khalil: None. K. Lee: None. G. Mudd-Martin: None. M. Biddle: None. T. Lennie: None. D.K. Moser: None.
- © 2014 by American Heart Association, Inc.