Hospitalization for depression is associated with an increased risk for myocardial infarction not explained by lifestyle, lipids, coagulation, and inflammation: the SHEEP Study.
BACKGROUND
Depression is considered a risk factor for coronary heart disease (CHD) in initially CHD-free populations. Subclinical CHD or other somatic causes of depressive symptoms might account for the association, however.


METHODS
In this case-control study, patients had had their first acute myocardial infarction (AMI). The study included 1799 cases, aged 45-70 years, and 2339, age-, gender-, and hospital-catchment-area-matched control subjects. We calculated odds ratios (OR) with 95% confidence intervals (CI) by multivariate logistic regressions to assess the AMI risk associated with a hospitalization for depression.


RESULTS
Forty-seven cases and 22 control subjects had been hospitalized for depression. After adjustment for matching criteria and socioeconomic status, the OR for AMI was 2.9 (1.8-4.9) for ever hospitalized for depression. Patients hospitalized for depression before or after the median time, 15 years and 2 months, between the first hospitalization for depression and AMI, were at similar risk. Adjustment for lifestyle, lipid profile, coagulation, inflammation, prior cardiovascular events, and comorbidity only partly decreased the observed association.


CONCLUSIONS
Depression was associated with increased risk for AMI. Subclinical CHD or other somatic causes are unlikely to account for our findings, which also appear not to be explained by established risk factors for AMI.
Janszky
Imre
I
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. imre.janszky@ki.se
Ahlbom
Anders
A
Hallqvist
Johan
J
Ahnve
Staffan
S
D000368:Aged; D001777:Blood Coagulation / Q000502:physiology; D016022:Case-Control Studies; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D015897:Comorbidity; D016001:Confidence Intervals; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007249:Inflammation / Q000453:epidemiology; D008019:Life Style; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D016017:Odds Ratio; D012307:Risk Factors; D012923:Social Class
D008055:Lipids