title: Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis of 25 years of research.
abstract: OBJECTIVE
  A meta-analysis of over 25 years of research into the relationship between post-myocardial infarction (MI) depression and cardiac prognosis was conducted to investigate changes in this association over time and to investigate subgroup effects.
  
  
  METHODS
  A systematic literature search was performed (Medline, Embase and PsycINFO; 1975–2011) without language restrictions. Studies investigating the impact of post-MI depression on cardiovascular outcome, defined as all-cause mortality, cardiac mortality and cardiac events within 24 months after the index MI, were identified. Depression had to be assessed within 3 months after MI using established instruments. Pooled odds ratios (ORs) were calculated using a random effects model.
  
  
  RESULTS
  A total of 29 studies were identified, resulting in 41 comparisons. Follow-up (on average 16 months) was described for 16,889 MI patients. Post-MI depression was associated with an increased risk of all-cause mortality [(OR), 2.25; 95% confidence interval [CI], 1.73-2.93; P<.001], cardiac mortality (OR, 2.71; 95% CI, 1.68–4.36; P<.001) and cardiac events (OR, 1.59; 95% CI, 1.37-1.85; P<.001). ORs proved robust in subgroup analyses but declined over the years for cardiac events.
  
  
  CONCLUSIONS
  Post-MI depression is associated with a 1.6- to 2.7-fold increased risk of impaired outcomes within 24 months. This association has been relatively stable over the past 25 years.
authors: Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen/University of Groningen, The Netherlands. anna.meijer@med.umcg.nl
authors: Anna
authors: A
authors: Meijer
authors: Henk Jan
authors: HJ
authors: Conradi
authors: Elisabeth H
authors: EH
authors: Bos
authors: Brett D
authors: BD
authors: Thombs
authors: Joost P
authors: JP
authors: van Melle
authors: Peter
authors: P
authors: de Jonge