WEDNESDAY, Jan. 19 (HealthDay News) -- Worsening symptoms of depression are associated with a poor prognosis in patients with heart failure, and routine assessment of these patients may help guide appropriate medical management, according to a study in the Jan. 25 issue of the Journal of the American College of Cardiology.
Andrew Sherwood, Ph.D., from the Duke University Medical Center in Durham, N.C., and colleagues assessed 147 patients with heart failure with ejection fractions less than 40 percent for symptoms of depression. Depression was measured using the Beck Depression Inventory (BDI) at baseline and after one year. Patients were followed up for an average of five years.
The researchers found that a change in depressive symptoms over one year, as indicated by higher BDI scores, was associated with death or cardiovascular hospitalization. This result was true after controlling for baseline depression and other established risk factors, such as cause of heart failure, age, prior hospitalizations, and measures of heart-failure severity: ejection fraction and N-terminal pro-B-type natriuretic peptide level. Patients with the highest increase in depressive symptoms were at more than twice the risk of adverse outcomes compared to patients with minimal increases.
"It may be prudent for clinicians to reassess symptoms of depression routinely in heart failure patients to determine better appropriate medical management of these patients who are at increased risk for adverse clinical outcomes and impaired quality of life," the authors write.
One of the study authors disclosed financial relationships with the pharmaceutical and medical device industries.
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