New onset depression following myocardial infarction predicts cardiac mortality
- PMID: 18434496
- DOI: 10.1097/PSY.0b013e31816a74de
New onset depression following myocardial infarction predicts cardiac mortality
Abstract
Objective: Studies investigating the effects of depression on mortality following myocardial infarction (MI) have produced heterogeneous findings. We report on a study investigating whether the timing of the onset of depression, with regard to the MI, affected its impact on subsequent cardiac mortality.
Methods: Five hundred and eighty-eight subjects admitted following MI underwent assessments of cardiac status, cardiac risk factors, and noncardiac illness. We identified separately subjects who were depressed before their MI (pre-MI depression) and those who developed depression in the 12 months after MI (new-onset depression), using a standardized questionnaire and a research interview. Patients dying of cardiac cause were identified during 8-year follow-up using information from death certificates.
Results: Multivariate predictors of cardiac death during follow-up included: greater age (hazards ratio (HR) = 1.06, p = .007), previous angina (HR = 4.15, p < .0005), high Killip Class (HR = 2.21, p = .013), prescription of beta-blockers on discharge (HR = 0.37, p = .02), and new-onset depression (HR = 2.33, p = .038). Pre-MI depression did not convey any additional risk of cardiac mortality.
Conclusion: We have shown increased cardiac mortality in patients who develop depression after suffering MI. Further observational studies need to separate pre- and post-MI depression if we are to determine underlying mechanisms by which depression is associated with mortality following MI.
Comment in
-
Developing depression after a myocardial infarction increases risk of cardiac mortality but pre-existing depression does not.Evid Based Ment Health. 2009 Feb;12(1):8. doi: 10.1136/ebmh.12.1.8. Evid Based Ment Health. 2009. PMID: 19176767 No abstract available.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical