Abstract 14937: Depressive Symptoms Were Not Associated With Cardiac Event-free Survival in Heart Failure Patients With Adequate Intake of Vitamin D
Introduction. Low levels of vitamin D and severe depressive symptoms have been associated with increased proinflammatory cytokines that predict cardiovascular disease. However, little is known about the relationships among depressive symptoms, vitamin D deficiency, and cardiac events in patients with heart failure (HF).
Hypothesis. We hypothesized that the link of depressive symptoms to cardiac event-free survival would differ between patients with vitamin D adequacy and deficiency.
Methods. A total of 232 patients with HF (age 66±8 years, 34% female) completed the Patient Health Questionnaire-9 to assess depressive symptoms and were split into 2 groups using the standard PHQ-9 cutoff point of 10. Nutrition Analysis program was used to determine average daily intake of vitamin D through a 3-day food diary. Patients with > 85% probability of deficiency were defined as having a diet deficient in vitamin D. Covariate data on age, gender, body mass index, NYHA class, ejection fraction, comorbidities, and prescribed medications were obtained from review of medical records. Patients were followed for 2 years to determine time to first event of hospitalization or death. Hierarchical Cox proportional regression was used to examine our hypothesis.
Results. 106 patients (46%) had depressive symptoms and 116 patients (50%) had vitamin D deficiency. During 2 years, 88 patients (38%) were hospitalized or died due to cardiac problems. Depressive symptoms were associated with vitamin D deficiency (X2=4.45, p= .035). In patients with vitamin D deficiency, depressive symptoms (HR=2.56, 95% CI=1.28-5.21) predicted shorter event-free survival after controlling for all covariates, whereas there was no difference in cardiac event-free survival between patients with depressive symptoms and no depressive symptoms in patients with vitamin D adequacy (p= .185) .
Conclusions. The data suggest that depressive symptoms were not associated with cardiac event-free survival in HF patients with adequate intake of vitamin D. Future study is required to determine whether vitamin D adequacy could play a protective role in the impact of depressive symptoms on cardiac event-free survival in patients with HF.
Author Disclosures: E. Song: Research Grant; Modest; the National Research Foundation (NRF) of Korea funded by the Korean Government (NRF-2011-0024857).. S. Kang: None. D.K. Moser: None. T.A. Lennie: None.
- © 2015 by American Heart Association, Inc.