Abstract P230: Antidepressant Use and Incident Heart Failure among Veterans with and without HIV Infection and Major Depressive Disorder
Depression is associated with an increased risk of heart failure (HF) among HIV infected (HIV+) and uninfected (HIV-) veterans. Antidepressants are commonly prescribed to mitigate psychosocial symptoms related to major depressive disorder (MDD). The purpose of this study was to determine whether antidepressant use was associated with lower HF risk among a large cohort of HIV+ and HIV- veterans with MDD. We analyzed data on 13,849 veterans (36.5% HIV+) from the Veterans Aging Cohort Study (VACS), a prospective study of HIV+ and matched HIV- veterans who had a diagnosis of MDD (ICD-9 codes 296.2x & 296.3x) and were free of cardiovascular disease (CVD) at baseline. Antidepressant use was defined as documentation of selective serotonin reuptake inhibitor (SSRIs), tricyclic antidepressant (TCAs), and non-SSRI, non-TCA antidepressant use from the VA pharmacy records during the baseline period (1998 - 2003). Incident HF was identified using ICD-9 codes and defined as first HF event on or after 4/1/2003 until 12/31/2009. We used Cox proportional hazards regression to assess the association between HIV infection, antidepressant use and incident HF, adjusting for covariates (Table). Most participants were on antidepressant therapy [90.2% (12,498 of 13,849)]. In the total sample, baseline antidepressant use was associated with a lower risk of HF, adjusting for all covariates including HIV (adjusted HR = 0.76, 95% CI = 0.58 - 0.99). The rates of incident HF were highest among HIV+ participants who did not use antidepressants (Table). Among the HIV+ participants, the association between antidepressant use and lower HF risk neared significance (p = 0.053). Antidepressant use was common among this cohort of veterans with MDD and was associated with a lower risk of incident HF. Our study lends support to further investigations to determine the importance of antidepressants as additional therapy for CVD prevention among MDD patients with and without HIV.
Author Disclosures: J.R. White: None. C.H. Chang: None. K.A. Armah: None. J.C. Stewart: None. S.K. Gupta: None. A.A. Butt: None. C.L. Gibert: None. D. Rimland: None. M.C. Rodriguez-Barradas: None. D.A. Leaf: None. R.J. Bedimo: None. J.S. Gottdiener: None. W.J. Kop: None. S.S. Gottlieb: None. M.J. Budoff: None. T. Khambaty: None. H.A. Tindle: None. A.C. Justice: None. M.S. Freiberg: None.
- © 2015 by American Heart Association, Inc.