Prognostic Implication of Earthquake‐Related Loss and Depressive Symptoms in Patients With Heart Failure Following the 2008 Earthquake in Sichuan

• Published in: Clinical cardiology (Mahwah, N.J.) N.J.), 2011-12, Vol.34 (12), p.755-760
• Main Authors: Huang, Kaisen, Deng, Xiaojian, He, Dingxiu, Huang, Dejia, Wu, Qi, Wen, Shuyin, Zhou, Yougen, Zhou, Fangming, Kang, Yingde, Chen, Mao
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Biological and medical sciences; Cardiology. Vascular system; China - epidemiology; Clinical Investigation; Clinical Investigations; Depression; Depression - complications; Depression - mortality; Disease-Free Survival; Earthquakes - mortality; Female; Follow-Up Studies; Heart; Heart Failure - mortality; Heart Failure - psychology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Male; Medical sciences; Miscellaneous; Mood disorders; Prognosis; Proportional Hazards Models; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Survival Analysis
• ISSN: 0160-9289; 1932-8737
• DOI: 10.1002/clc.20947

Background: Earthquake exposure is associated with adverse consequences for cardiovascular disease. However, in the context of depressive symptoms, the prognostic significance of heart failure (HF) related to earthquake‐related loss has not been characterized before. Hypothesis: To determine the prognostic impact of earthquake‐related loss on event‐free survival in patients with HF, with depression as a modifying factor. Methods: Depressive symptoms were assessed by using the Zung Self‐Rating Depression Scale in 404 HF patients who were followed up for 2 years after the earthquake to collect data on mortality and readmission. The Kaplan‐Meier method was used to compare event‐free survival between patients with and without earthquake‐related loss. Cox proportional hazard regression modeling was used to examine the predicted outcomes for baseline variables. Results: The proportion of patients with moderate/severe depressive symptoms among the HF patients with earthquake‐related loss is much higher than their counterparts (27.038% vs 17.84%, P = 0.039). Heart failure patients without loss experienced longer event‐free survival than patients with loss (P = 0.002), especially among patients without depressive symptoms (P = 0.003). Meanwhile, in a Cox proportional hazard regression model, the event‐free survival was associated with earthquake‐related loss, left ventricular ejection fraction, depressive symptoms, and chronic obstructive pulmonary disease or asthma. Conclusions: Heart failure patients without earthquake‐related loss experienced longer event‐free survival than did HF patients with severe loss. Earthquake‐related loss was a predictor of poor outcomes in HF patients, particularly in patients without depression. © 2011 Wiley Periodicals, Inc. The work was supported by grants from the National High‐Tech Research and Development Program of China (2008AA022601). The authors have no other funding, financial relationships, or conflicts of interest to disclose.