Post-discharge depressive symptoms can predict quality of life in AMI survivors: a prospective cohort study in Japan.
BACKGROUND
Reports on health-related quality of life (HRQOL) of Asian populations after acute myocardial infarction (AMI) and its predictors are rare. We describe the longitudinal HRQOL course after AMI, hypothesizing that post-discharge depressive symptoms predict poor recovery of HRQOL in Japan.


METHODS
AMI survivors participated in a prospective cohort study of AMI patients admitted to 5 hospitals in Japan. Data from 218 consecutive male patients were analyzed. HRQOL was measured with Short-Form Health Survey-36 at 1, 6, and 12 months post-discharge. Five-question Mental Health Inventory (MHI-5) assessed presence of depressive symptoms. Multiple linear regression analyzed the relationship between depressive symptoms at 1 month and recovery of HRQOL at 6 months.


RESULTS
AMI patients at 12 months after discharge had lower HRQOL in physical function (47.8), role-physical (44.1), general health (46.4), social function (47.4), and role-emotional (45.8) than the Japanese national norm. Impairment of each domain of HRQOL was seen in 36%-71% of patients. Multivariate analysis showed that depressive symptoms at 1 month post-discharge adversely affected recovery of physical function (β = -2.62; CI: -5.00 to -0.23), role-physical (β = -3.50; CI: -6.94 to -0.06) and bodily pain (β = -2.92; CI: -5.26 to -0.59) at 6 months.


CONCLUSIONS
Despite good prognosis for survival of discharged AMI patients, HRQOL did not recover to the national norm. Post-discharge depressive symptoms were significantly associated with poor recovery of the physical component of HRQOL. Increasing awareness of depressive symptoms in discharged AMI patients may improve survivor HRQOL.
Sakai
Michi
M
Department of Epidemiology and Healthcare Research, Kyoto University School of Public Health, Konoe-cho, Yoshida, Sakyo-ku, City of Kyoto, Kyoto 606-8501, Japan. sakai.michi1@gmail.com
Nakayama
Takeo
T
Shimbo
Takuro
T
Ueshima
Kenji
K
Kobayashi
Noboru
N
Izumi
Toru
T
Sato
Naoki
N
Yoshiyama
Minoru
M
Yamashina
Akira
A
Fukuhara
Shunichi
S
D003863:Depression / Q000453:epidemiology*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D010351:Patient Discharge; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D017741:Survivors