Depressive symptoms and all-cause mortality after heart transplantation

BACKGROUND: Several studies indicate that heart transplantation (HTx) is associated with depression and reduced quality of life. However, the impact of depression on the prognosis for HTx-patients has not yet been sufficiently established. The aim of the present study was to prospectively investigate the influence of depression on mortality in patients with HTx, adjusting for other known risk factors. METHODS: In a prospective, cross-sectional study with minimum 5-year follow-up, symptoms of depression were assessed in 147 HTx-patients using the Beck Depression Inventory (BDI). RESULTS: Mild to severe depressive symptoms (BDI > or =10) were observed in 36 patients (24.5%). Depressive symptoms on inclusion increased the risk of mortality during the follow-up period. The risk remained significant after adjusting for several somatic and lifestyle risk factors, and the adjusted relative risk associated with depression (risk ratio: 2.32; 95% CI: 1.13-4.79; P=0.02) was comparable to the adjusted relative risk associated with time since HTx. CONCLUSIONS: Symptoms of depression predict mortality independently of somatic and lifestyle risk factors in HTx patients, and this group of patients should be screened for depressive symptoms.