title: Decreased impact of post-myocardial infarction depression on cardiac prognosis?
abstract: 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.
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Titia A
authors.initials: TA
authors.lastname: Spijkerman
authors.forename: Rob H S
authors.initials: RH
authors.lastname: van den Brink
authors.forename: Jo F
authors.initials: JF
authors.lastname: May
authors.forename: Jobst B
authors.initials: JB
authors.lastname: Winter
authors.forename: Joost P
authors.initials: JP
authors.lastname: van Melle
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.forename: Harry J G M
authors.initials: HJ
authors.lastname: Crijns
authors.forename: Johan
authors.initials: J
authors.lastname: Ormel
mesh_terms: 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