Abstract 222: Paradoxical Favorable Clinical In-hospital Outcomes In Geriatric HF(pEF) Patients With Depression

Background: Depression has been identified as a risk factor for acute cardiovascular events. Considering limited data on the subject, we studied the burden and impact of comorbid depression on heart failure with preserved affection fraction (HFpEF)-related hospitalizations and outcomes using a nationally representative sample. Methods: Elderly (≥65 years) patients’ hospitalizations with HFpEF (after excluding HFrEF) were extracted from the National Inpatient Sample 2018 (ICD-10) and divided into with or without comorbid depression. Demographics, clinical profile and major cardiovascular and cerebrovascular events (MACCE, all-cause mortality, AMI, cardiac arrest and stroke) were compared between cohorts. Multivariable regression analysis was performed controlling covariates to assess the risk of MACCE in geriatric HFPEF admissions with depression. Results: Of 1,599,220 HFpEF hospitalizations in elderly patients (median age 80 years, 61.1% females) 14.1% (n=224,970) had comorbid depression (median age 77 years, 70.6% females). Females had a higher depression prevalence than males (16.2 vs. 10.6%, p<0.001). The HFpEF-depression arm often had relatively younger (77 vs. 80 years), white (83.1 vs. 76.1%), female (70.6 vs. 59.6%) patients with a significantly higher burden of CVD risk factors including hypertension, DM, hyperlipidemia, obesity, smoking, prior MI/TIA/stroke, alcohol abuse, anxiety-related and bipolar disorder vs. non-depression arm. Interestingly, the depression arm had a significantly lower rate (10.9% vs. 13.6%) and lower odds of MACCE (aOR 0.85, 95CI 0.82-0.88) when adjusted for sociodemographic confounders and comorbid risk factors (p<0.001) [Table 1] . Conclusion: The elderly patients with HFpEF have a high burden (female>males, whites>non-whites) of comorbid depression, however, our analysis revealed the “depression paradox” effect for in-hospital MACCE in geriatric HFpEF admissions and needs further evaluation.