Heart and Mind: TAVR Outcomes Linked to Depression

Screening for depression in patients undergoing transcatheter (TAVR) or surgical (SAVR) aortic valve replacement may be justified, according to the results of a recent study.

Although depression has been shown to affect outcomes in patients with cardiovascular disease, little is known about the effects of depression on adults undergoing TAVR and SAVR.
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The researchers conducted a preplanned analysis of the Frailty Aortic Valve Replacement (FRAILTY-AVR) prospective cohort study including 1035 adults, aged 70 years or older, who underwent TAVR or SAVR in 14 centers in 3 countries. The Geriatric Depression Scale Short Form was used to evaluate depression at baseline and follow-up.

Overall, 326 participants (31.5%) had a positive screen for depression, while only 89 (8.6%) had depression documented within their clinical record. Baseline depression was associated with mortality at 1 month (odds ratio [OR] 2.20) and 12 months (OR 1.532). Persistent depression was associated with a 3-fold increase in mortality at 12 months.

“These findings underscore the importance of screening for depression during the baseline evaluation and reevaluating changes in depression status during follow-up,” the researchers concluded.

—Michael Potts

Reference:

Drudi LM, Ades M, Turkdogan S, et al. Association of depression with mortality in older adults undergoing transcatheter or surgical aortic valve replacement [published online January 17, 2018]. JAMA Cardiol. doi:10.1001/jamacardio.2017.5064