Impact of clustered depression and anxiety on mortality and rehospitalization in patients with heart failure

Tsuyoshi Suzuki, Tsuyoshi Shiga, Kazue Kuwahara, Sayaka Kobayashi, Shinichi Suzuki, Katsuji Nishimura, Atsushi Suzuki, Yuichiro Minami, Jun Ishigooka, Hiroshi Kasanuki, Nobuhisa Hagiwara

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    20 Citations (Scopus)

    Abstract

    Anxiety is often present in patients with depression. The aim of this study was to evaluate the impact of clustered depression and anxiety on mortality and rehospitalization in hospitalized patients with heart failure (HF). Methods: A total of 221 hospitalized patients with HF, who completed the questionnaires, were analyzed in this prospective study (mean age 62. ±. 13 years; 28% female). One-third patients had implanted cardiac devices. Depression was defined as a Zung Self-Rating Depression Scale index score of ≥60 and anxiety was defined as a State-Trait Anxiety Inventory score of ≥40 (male) or ≥42 (female). The primary outcome was the composite of death from any cause or rehospitalization due to worsened HF and refractory arrhythmia. Results: Of the 221 HF patients, 29 (13%) had depression alone, 80 (36%) had anxiety alone, and 46 patients (21%) had both depression and anxiety. During an average follow-up of 41. ±. 21 months, patients with depression alone and those with clustered depression and anxiety were at an increased risk of the primary outcome [hazard ratio (HR) 2.24, 95% confidence interval (CI): 1.17-4.28, p = 0.01 and HR 2.75, 95% CI: 1.51-4.99, p = 0.01, respectively] compared to patients with no symptoms. Multivariate analysis after adjusting for age, gender, New York Heart Association functional class, B-type natriuretic peptide, device implantation, renal dysfunction, and left ventricular dysfunction showed clustered depression and anxiety, but not depression alone or anxiety alone, was an independent predictor of the primary outcome (HR 1.96, 95% CI: 1.00-3.27, p = 0.04). Conclusions: Our results showed that clustered depression and anxiety were associated with worse outcomes in patients with HF.

    Original languageEnglish
    Pages (from-to)456-462
    Number of pages7
    JournalJournal of Cardiology
    Volume64
    Issue number6
    DOIs
    Publication statusPublished - 2014

    Keywords

    • Anxiety
    • Cluster
    • Depression
    • Heart failure
    • Outcome

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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  • Cite this

    Suzuki, T., Shiga, T., Kuwahara, K., Kobayashi, S., Suzuki, S., Nishimura, K., Suzuki, A., Minami, Y., Ishigooka, J., Kasanuki, H., & Hagiwara, N. (2014). Impact of clustered depression and anxiety on mortality and rehospitalization in patients with heart failure. Journal of Cardiology, 64(6), 456-462. https://doi.org/10.1016/j.jjcc.2014.02.031