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

• Depression after HF and mortality risk has been reported the conflicting results.
• A meta-analysis was performed on depression after HF and mortality risk.
• Major depression after HF significantly increased the all-cause mortality risk.
• Routine evaluation depression after HF will help to identify mortality risk.

ObjectivesThe 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.MethodsPubmed, Embase, and PsycInfo 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 (CI) were calculated separately for categorical risk estimates.ResultsNine studies with 4012 HF patients were identified and analyzed. Pooled HR of all-cause mortality was 1.51 (95% CI 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% CI 1.23–3.19), but not mild depression (HR = 1.04, 95% CI 0.75–1.45). Pooled HR of cardiovascular mortality was 2.19 (95% CI 1.46–3.29) for depression compared with non-depressive patients.ConclusionMajor 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.