Dr hab. n. med. Robert Pudlo
Wpływ leczenia psychiatrycznego na rokowanie w chorobach układu krążenia.
Objectives: Chronic heart failure (HF) is associated with significantly increased prevalence of depression. The aim of the study was to assess the incidence, clinical impact of depression and effectiveness of depression treatment in HF-patients.
Methods: The prospective, interventional, trial included 285 consecutive cardiac resynchronization therapy recipients. Patients underwent a psychiatric examination at the time of implantation and then it was routinely repeated at 3, 6,12 months after the procedure, and every 6 months thereafter. 135 (47.4%) patients with depression were included into
Depression Group whereas Control Group encompassed 150 patients free of depression. 68 (50.4%) subjects received antidepressants (Treated Group), whereas Observational Group encompassed 67 (49.6%) depressed patients, who refused to take antidepressants.
Results: Depression remission was achieved in 51 (75.0%) patients from Treated Group. The long-term mortality and incidence of hospitalization for HF were significantly higher in Depression Group than in Control Group (20.7% vs. 11.3%; 32.6% vs. 19.2%, respectively). However, remission from depression was associated with a 40% reduction in the relative risk of major adverse cardiac events.
Conclusions: Patients with heart failure and concomitant depression are at higher risk of major adverse cardiac events. Effective antidepressant treatment might significantly improve a long-term outcome in this population.