Heart failureCharacteristics of Depression Remission and Its Relation With Cardiovascular Outcome Among Patients With Chronic Heart Failure (from the SADHART-CHF Study)
Section snippets
Methods
The SADHART-CHF database was used for this analysis. A detailed method of the SADHART-CHF trial has been previously published.10, 13 SADHART-CHF was a randomized double-blind study of sertraline versus matching placebo in patients with HF and co-morbid major depression. In addition, all participants received nurse-facilitated support (NFS). Primary end points of the SADHART-CHF trial were change across time in severity of depression as measured by the Hamilton Depression Rating Scale (HDRS)
Results
In total 469 participants were enrolled in SADHART-CHF at Duke University Medical Center and 3 Duke Health System affiliates from August 13, 2003 to March 3, 2008. The primary analysis of SADHART-CHF has been previously reported.13 Of the 469 SADHART-CHF participants, 208 patients (44.3%) had HDRS scores that improved to <8, whereas 194 (41.4%) patients had a HDRS ≥8 at the end of 12-week intervention. There were 67 subjects (14.3%) who did not have any repeat HDRS during the 12-week acute
Discussion
This analysis of the SADHART-CHF trial demonstrated an association of depression remission during the 12-week active intervention and significantly decreased fatal and nonfatal cardiovascular events. Such findings support the hypothesis that successful depression treatment may be associated with a cardiac benefit in patients with HF. Carney et al11 performed a post hoc analysis in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study to examine whether depression remission at 6
Acknowledgment
We thank Pfizer, Inc., New York, New York, for supplying the study drug.
References (30)
- et al.
Psychological predictors of prognosis in chronic heart failure
J Card Fail
(2008) - et al.
Depression in heart failure- A meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes
J Am Coll Cardiol
(2006) - et al.
Congestive heart failure—relationship between depressive symptoms and long-term mortality in patients with heart failure
Am Heart J
(2007) - et al.
Depression is a major determinant of quality of life in patients with chronic systolic heart failure in general practice
J Card Fail
(2007) - et al.
Depressive symptoms are the strongest predictors of short-term declines in health status in patients with heart failure
J Am Coll Cardiol
(2003) - et al.
Depressive symptoms and risk of functional decline and death in patients with heart failure
J Am Coll Cardiol
(2001) - et al.
Safety and efficacy of sertraline for depression in patients with heart failure: results of the SADHART-CHF trial
J Am Coll Cardiol
(2010) - et al.
Safety and efficacy of sertraline for depression in patients with CHF (SADHART-CHF): a randomized, double-blind, placebo-controlled trial of sertraline for major depression with congestive heart failure
Am Heart J
(2008) - et al.
Doctor-patient communication—a review of the literature
Soc Sci Med Soc Sci Med
(1995) - et al.
Assessing the efficacy of antidepressants: the transactional paradigm
Med Hypotheses
(2005)
Depressive symptoms and six-year cardiovascular mortality in elderly patients with and without heart failure
Scand Cardiovasc J
Depression and cardiac mortality—results from a community-based longitudinal study
Arch Gen Psychiatry
Depression and major outcomes in older patients with heart failure
Arch Intern Med
Depression and late mortality after myocardial infarction in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study
Psychosom Med
Psychiatric characteristics associated with Long-term mortality among 361 patients having an acute coronary syndrome and Major depression seven-year follow-up of SADHART participants
Arch Gen Psychiatry
Cited by (88)
Depression Subtypes in Systolic Heart Failure: A Secondary Analysis From a Randomized Controlled Trial
2023, Journal of the Academy of Consultation-Liaison PsychiatryDepression and cardiovascular diseases
2023, Journal of CardiologyPsychological Disorders in Heart Failure
2022, Cardiology ClinicsDepressive Symptoms and Incident Heart Failure Risk in the Southern Community Cohort Study
2022, JACC: Heart FailureAssociations Between Depressive Symptoms and HFpEF-Related Outcomes
2020, JACC: Heart FailurePsychological Disorders in Heart Failure
2020, Heart Failure Clinics
The SADHART-CHF study was funded by the National Institute of Mental Health, Bethesda, Maryland.