Depressive symptoms and poor social support have a synergistic effect on event-free survival in patients with heart failure.

BACKGROUND Depressive symptoms and poor social support are predictors of increased morbidity and mortality in patients with heart failure (HF). However, the combined contribution of depressive symptoms and social support event-free survival of patients with HF has not been examined. OBJECTIVE To compare event-free survival in 4 groups of patients with HF stratified by depressive symptoms and perceived social support (PSS). METHOD A total of 220 patients completed the Beck Depression Inventory-II and the Multidimensional Perceived Social Support Scale and were followed for up to 4 years to collect data on death and hospitalizations. RESULTS Depressive symptoms (hazard ratio = 1.73, P = .008) and PSS (hazard ratio = 1.51, P = .048) were independent predictors of event-free survival. Depressed patients with low PSS had 2.1 times higher risk of events than non-depressed patients with high PSS (P = .003). CONCLUSION Depressive symptoms and poor social support had a negative additive effect on event-free survival in patients with HF.