title: Initiation of statin therapy after acute myocardial infarction is not associated with worsening depressive symptoms: insights from the Prospective Registry Evaluating Outcomes After Myocardial Infarctions: Events and Recovery (PREMIER) and Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH) registries.
abstract: BACKGROUND
  Whereas statins are considered the cornerstone of prevention after acute myocardial infarction (AMI), concerns about worsening depression in association with their use have been raised.
  
  
  METHODS
  Using data from 2 prospective AMI registries (PREMIER and TRIUMPH), we examined the change in depressive symptoms from baseline and at 1, 6 and 12 months among statin-naïve patients who were and were not discharged on a statin. Depressive symptoms were assessed with the 8-item Patient Health Questionnaire (PHQ-8). Within-group change in PHQ-8 scores from baseline to each follow-up period was assessed using paired t tests. A repeated-measures propensity-matched analysis examined whether changes in PHQ-8 scores from baseline were different between statin-treated and statin-untreated patients.
  
  
  RESULTS
  Of 3,675 patients not previously treated with statins, 3,050 (83%) were discharged on a statin and 625 (17%) were not. Scores of PHQ-8 in the statin group decreased from baseline by a mean (± SD) of 0.9 (± 5.1), 1.2 (± 5), and 1.1 (± 5.1) at 1, 6, and 12 months, respectively. Corresponding changes in the nonstatin group were 0.9 (± 5.2), 1.3 (± 5.1), and 1.5 (± 5.8), respectively (P < .0001 for all comparisons). After propensity matching, 451 patients not discharged on statins with 1,240 patients discharged on statins, the mean change in PHQ-8 scores between baseline and the 3 follow-up time points was not significantly different between groups (mean between-group difference at 1 month: -0.13, 95% CI [-0.69 to 0.43], P = .65; at 6 months: -0.07, 95% CI [-0.66 to 0.52], P = .82; and at 12 months: -0.05, 95% CI [-0.67 to 0.58], P = .88).
  
  
  CONCLUSIONS
  Initiation of statins after AMI was not associated with worsening depression.
authors.affiliation: Saint Luke's Mid America Heart Institute, Kansas City, MO; University of Missouri-Kansas City, Kansas City, MO; Prairie Heart Institute of Southern Illinois, Carbondale, IL. Electronic address: albadarin@gmail.com.
authors.forename: Firas J
authors.initials: FJ
authors.lastname: Al Badarin
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.forename: Kensey L
authors.initials: KL
authors.lastname: Gosch
authors.forename: Donna M
authors.initials: DM
authors.lastname: Buchanan
authors.forename: Paul S
authors.initials: PS
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006304:Health Status; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D011795:Surveys and Questionnaires; D057170:Translational Research, Biomedical; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors