Depression ups mortality risk post aortic valve replacement

(HealthDay)—The presence of depressive symptoms among older adults undergoing transcatheter (TAVR) or surgical (SAVR) aortic valve replacement increases the risk of mortality, according to research published online Jan. 17 in JAMA Cardiology.

Laura M. Drudi, M.D., from Jewish General Hospital in Montreal, and colleagues assessed depressive symptoms in preplanned analysis of the Frailty Aortic Valve Replacement prospective cohort study (14 centers in three countries from Nov. 15, 2011, through April 7, 2016). Participants included individuals (mean age, 81.4 years) who underwent TAVR or SAVR aortic valve replacement.

Among 1,035 participants, the researchers found that 31.5 percent had a positive screening result for depression, but only 8.6 percent had depression documented in their clinical record. Baseline depression was associated with mortality at one month (odds ratio, 2.20) and at 12 months (odds ratio, 1.532), after adjusting for clinical and geriatric confounders. There was a three-fold increase in mortality at 12 months (odds ratio, 2.98) among participants with persistent depression (still present six months after the procedure).

"One in three older adults undergoing TAVR or SAVR had depressive symptoms at baseline and a higher risk of short-term and midterm mortality," the authors write. "Patients with persistent depressive symptoms at follow-up had the highest risk of mortality."

Several authors disclosed financial ties to the pharmaceutical industry.