Depression after heart failure and risk of cardiovascular and all-cause mortality: A meta-analysis

Objectives. The aim of this study is to investigate whether depression after heart failure (HF) was a predictor for subsequent cardiovascular and all-cause mortality in prospective observational studies. Methods. Pubmed, Embase, and Psyclnfo databases were searched for prospective studies reported depression after HF and subsequent risk of cardiovascular or all-cause mortality (prior to May 2013). Pooled adjust hazard ratio (HR) and corresponding 95% confidence intervals (Cl) were calculated separately for categorical risk estimates. Results. Nine studies with 4012 HF patients were identified and analyzed. Pooled HR of all-cause mortality was 1.51 (95% Cl 1.19-1.91) for depression compared with non-depressive patients. Subgroup analyses showed that major depression significantly increased all-cause mortality (HR = 1.98, 95% Cl 1.23-3.19), but not mild depression (HR = 1.04, 95% Cl 0.75-1.45). Pooled HR of cardiovascular mortality was 2.19 (95% Cl 1.46-3.29) for depression compared with non-depressive patients. Conclusion. Major depression after HF was a predictor for subsequent all-cause mortality, but not mild depression. More well-designed studies are needed to explore the influence of depression and antidepressant medication use on cardiovascular and all-cause mortality in HF patients. (C) 2014 Elsevier Inc. All rights reserved.