Depression tied to increased risk for HF, death in hypertrophic cardiomyopathy

The diagnosis of depression is strongly associated with increased risk for sudden cardiac death and HF events in patients with hypertrophic cardiomyopathy, researchers reported.

Researchers analyzed 856 hospitalized patients in China aged at least 18 years with hypertrophic cardiomyopathy (HCM), of whom 23.4% were diagnosed with depression.

During a mean 4.2 years of follow-up, 75 participants had a sudden cardiac death (SCD) event (21.8 per 1,000 person-years) and 149 developed HCM-related HF (43.3 per 1,000 person years), according to the researchers.

In a univariate regression model, depression was linked to increased risk for SCD events (HR = 2.1; 95% CI, 1.8-2.4; P < .001) and HCM-related HF (HR = 2; 95% CI, 1.6-2.3; P < .001), the researchers wrote.

According to the researchers, depression was an independent predictor of SCD events and HCM-related HF (HR for SCD = 1.9; 95% CI, 1.6-2.3; P < .001; HR for HCM-related HF = 1.8; 95% CI, 1.6-2.1; P < .001).

When the analysis was limited to SCD events other than implantable cardioverter defibrillator discharge, the risk for SCD events remained elevated in patients with depression (HR = 1.5; 95% CI, 1.2-1.9; P < .001), the researchers wrote.

The researchers also found the following clinical outcomes were elevated in patients with depression compared with those without it:

• sudden deaths (109 vs. 38 per 1,000 person-years; HR = 3.3; 95% CI, 1.8-5.9);
• aborted arrests (15 vs. 6 per 1,000 person-years; HR = 2.4; 95% CI, 1.3-4.8);
• ICD discharges (47 vs. 22 per 1,000 person-years; HR = 2.2; 95% CI, 1.2-4.7);
• deaths from HF (26 vs. 16 per 1,000 person-years; HR = 1.7; 95% CI, 1-3.3);
• HF hospitalizations (47 vs. 30 per 1,000 person-years; HR = 1.7; 95% CI, 1.2-3.5); and
• HF symptoms that progressed to NYHA class III/IV (198 vs. 81 per 1,000 person-years; HR = 2.5; 95% CI, 1.9-4.4).

“Further study should be encouraged to validate whether psychological intervention for depression can improve clinical outcomes in this population,” the researchers wrote.