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Prevalence of Depression and Antidepressant Use in Cardiac Transplant Candidates and Recipients

D. Wood1, N. R. Konopasek2, J. Powers2, G. Kim2, M. Marcangelo3, L. Lourenco1

1Pharmacy, University of Chicago Medicine, Chicago, IL, 2Cardiology, University of Chicago Medicine, Chicago, IL, 3Psychiatry, University of Chicago Medicine, Chicago, IL

Meeting: 2020 American Transplant Congress

Abstract number: C-283

Keywords: Heart, Heart transplant patients, Psychiatric comorbidity

Session Information

Session Name: Poster Session C: Heart and VADs: All Topics

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: A diagnosis of depression can have negative impacts such as graft loss, suicidal ideation, and mortality in patients pre- and post-heart transplantation (HT). This study aimed to evaluate the formal identification of depression alongside the utilization of antidepressants in patients pre- and post-HT.

*Methods: This was a single-center, retrospective study from January 2008 to October 2019 including patients pre- and post-HT. Formal pre- and post-HT diagnosis of depression was evaluated. Concurrent antidepressant use with or without a formal diagnosis of depression was also characterized. Data were analyzed using McNemar tests. Variables including weight gain, medication non-adherence, documented history of suicidal ideation, hospital readmission due to psychiatric illness, and mortality were analyzed.

*Results: A total of 356 patients were included in the analysis; 275 (77%) were male. Median age was 60 years. Average post-HT weight gain was 4.4 kg. 44 (13%) had a documented history of medication non-adherence pre- or post-HT. 8 (2%) had a documented history of suicidal ideation pre- or post-HT. 9 (3%) experienced inpatient readmission due to psychiatric illness pre- or post-HT. 56 (16%) experienced mortality and 7 patients were lost to follow-up. In comparing pre-HT patients to post-HT patients, post-HT patients were more likely to have a formal diagnosis of depression (14% vs. 25%, p<0.001). In comparing pre-HT patients to post-HT patients, post-HT patients were more likely to be on an antidepressant (22% vs. 44%, p<0.001). 46 patients out of 88 (52%) with a diagnosis of depression post-HT were new diagnoses. 93 patients out of 156 (60%) on antidepressants were using antidepressants for the first time post-HT. In contrast, 15 out of 78 (19%) patients using antidepressants pre-HT were not using antidepressants post-HT.

*Conclusions: Clinical diagnosis of depression and antidepressant use was found to be statistically higher in patient’s post-HT versus pre-HT. This research emphasizes the magnitude of recognizing psychiatric comorbidities in the already vulnerable transplant population. With a better understanding of the barriers to optimal evaluation and treatment, practice advances to optimize the management of depression pre- and post-HT can be made.

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To cite this abstract in AMA style:

Wood D, Konopasek NR, Powers J, Kim G, Marcangelo M, Lourenco L. Prevalence of Depression and Antidepressant Use in Cardiac Transplant Candidates and Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/prevalence-of-depression-and-antidepressant-use-in-cardiac-transplant-candidates-and-recipients/. Accessed June 6, 2025.

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