Association of depression and anxiety before heart transplant with mortality after transplant: a single-center experience

Objective: The purpose of this study was to evaluate the effects of depression and anxiety before heart transplant on all-cause mortality after heart transplant in a Northern California cohort. Methods: A total of 130 adult patients with heart transplants enrolled at Kaiser Permanente between June 2005 and December 2013 were included in a retrospective chart review. Preoperative depression and anxiety, evidenced by diagnoses, and other risk factors for all-cause mortality were investigated. Statistical methods included Kaplan–Meier survival analysis and Cox proportional hazard regression models. Results: After risk adjustment, patients with preoperative depression and anxiety diagnoses had higher risk of all-cause mortality at 2 years (hazard ratio [HR] = 4.2, 95% confidence interval [CI]: 1.1, 15.0, p = 0.03) and 3 years (HR = 3.7, 95% CI: 1.2, 11.9, p = 0.04) following heart transplant than those without depression or anxiety. This finding did not reach statistical significance at 5 years post-heart transplant (HR = 2.0, 95% CI: 0.8, 5.3, p = 0.14). Conclusion: The findings suggest an association between preoperative depression and anxiety with mortality in heart transplant patients 2 and 3 years post-transplant.