Decreased impact of post-myocardial infarction depression on cardiac prognosis?
OBJECTIVE
A recent meta-analysis suggests that the impact of post-myocardial infarction (MI) depression on cardiac prognosis has decreased over the last decade. We tested whether depression still significantly affects prognosis in the present health care situation.


METHODS
Four hundred ninety-four MI patients were screened for depression. Patients with depression were compared with patients without on cardiovascular events (fatal or nonfatal) during an average follow-up of 2.5 years. Demographic characteristics and cardiac risk factors were controlled for.


RESULTS
We found that depression was associated with the occurrence of cardiovascular events in both univariate [hazard ratio (HR), 1.84; 95% confidence interval, 1.24-2.72] and multivariate analysis (HR, 1.56; 1.02-2.38).


CONCLUSIONS
Depression still has an independent impact on cardiac prognosis after MI, but this influence is smaller than found in early studies. Improvements in general care for MI and better recognition and treatment of post-MI depression may have decreased the impact of depression on prognosis.
Spijkerman
Titia A
TA
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
van den Brink
Rob H S
RH
May
Jo F
JF
Winter
Jobst B
JB
van Melle
Joost P
JP
de Jonge
Peter
P
Crijns
Harry J G M
HJ
Ormel
Johan
J
D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000523:psychology*; D011379:Prognosis; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013997:Time Factors