Liu CH, Wang JH, Weng SC, Cheng YH, Yeh MK, Bai MY, Chang JC. J. Card. Fail. 2018; 24(11): 795-800.
Affiliation
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: jungchenchang@ntu.edu.tw.
BACKGROUND AND OBJECTIVES: The high prevalence of heart failure (HF) in developed countries imposes a substantial burden on health care resources. Depression is widely recognized as a risk factor associated with HF. This study examined the relationship between suicide and HF after controlling for depression and other comorbidities.
METHODS: The population comprised 52 749 adult patients who died from suicide between 2000 and 2012 and 210 996 living controls matched by age, sex, and residence area. Data were obtained from the Health and Welfare Data Science Center, Taiwan. Multivariable models were constructed to evaluate the relationship between HF and suicide.
RESULTS: In the case and control groups, 1624 (3.08%) and 4053 (1.92%) patients had HF, respectively, indicating that HF was associated with an increased risk of suicide (OR = 1.68, 95% CI: 1.59-1.79). The risk of suicide was highest during the initial 6 months post-HF (adjusted OR = 7.04, 95% CI: 5.37-9.22) and subsequently declined gradually. Among psychiatric disorders, mood disorders (aOR = 7.42, 95% CI: 7.06-7.79) yielded the highest odds of suicide.
CONCLUSIONS: The risk of suicide is higher for patients with HF than for healthy individuals without HF. This risk is particularly high during the first 6 months after HF diagnosis. This study provides strong evidence that depression is a negative prognostic factor for patients with HF and increases the risk of suicide. The results suggest early screening and treatment for depression and suicide risk should be conducted for patients with HF.