2227-PUB: Relationship between Depression and Cardiovascular Outcomes in T2DM Patients: A Propensity Score-Matched Analysis of ACCORD Trial

Background: Despite the fact that depression increases risk for cardiovascular disease (CVD), there has met a controversy that evidences linking well depression management to CVD outcomes improvement have yet to be established. In this study, we aim to explore relationship between depression and CVD outcomes among T2DM patients in intensive and standard glycemic therapy cohort.

Method: The ACCORD database was divided into intensive glycemic therapy cohort and standard cohort. And we applied logistic regression model to assess the association between depression and CVD outcomes (primary outcome and secondary outcomes), using the propensity score method to adjust for age, gender, BMI, waist, CVD history, race, live alone, education, SBP, DBP, TRIG, CPK, alcohol, VLDL, heart failure and smoke in each cohort.

Result: 2272 patients were included in the standard glycemic therapy cohort and 2192 in the intensive cohort finally. Propensity score adjusted logistic models showed that there was no significant difference in CVD outcomes between depressed and non-depressed patients in the standard glycemic therapy cohort. While in the intensive glycemic therapy cohort, the risk of congestive heart failure was significantly higher in patients with depression than in the non-depressed group (p=0.019, OR: 1.608, 95% CI: 1.082-2.39). Besides, depressed patients seemed to more likely to develop non-fatal myocardial infarction (P=0.058, OR: 1.417, 95% CI: 0.989-2.032).

Conclusion: On equal terms, T2DM patients with depression have a greater risk of congestive heart failure in patients receiving intensive glycemic therapy, while a larger prospective randomized controlled trial focusing on this endpoint is needed to verify our result.