title: Components of depression and 6-year mortality after an acute coronary syndrome.
abstract: BACKGROUND
  Post-myocardial infarct depression includes both somatic depressive symptoms and nonsomatic cognitive symptoms. Their respective relationships to long-term survival are unclear.
  
  
  METHODS
  Depression was diagnosed by measuring the Beck Depression Inventory-II (BDI-II) on consecutive patients who presented with acute coronary syndrome in 2005. Six-year mortality data were extracted from the National Health Index. This study investigated whether mortality was related to the somatic or cognitive elements of the BDI-II score, controlling for baseline characteristics including the Global Registry of Acute Coronary Events score. The BDI-II, somatic, and cognitive scores were treated as continuous variables.
  
  
  RESULTS
  Of the 277 patients, 52 died over 6 years. Higher BDI-II score did not predict mortality at 6 years (odds ratio [OR], 1.02; 95% confidence interval [CI], 0.98-1.06). In the Cognitive/Affective-Somatic model, somatic depressive symptoms (OR, 1.10; 95% CI, 1.01-1.20) predicted all-cause mortality, but cognitive/affective depressive symptoms (OR, 1.01; 95% CI, 0.96-1.08) did not. This association attenuated after controlling for age and sex (OR, 1.10; 95% CI, 0.99-1.22), and age, sex, and Global Registry of Acute Coronary Events score (OR, 1.09; 95% CI, 0.99-1.21). Results from the Somatic/Affective-Cognitive model did not reach statistical significance. Differences were small and unlikely to be of clinical importance.
  
  
  CONCLUSIONS
  In patients with acute coronary syndrome, those who died had a higher baseline BDI-II score, particularly somatic score, although this did not reach statistical significance.
authors.affiliation: Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Electronic address: peter.herbison@otago.ac.nz.
authors.forename: Peter
authors.initials: P
authors.lastname: Herbison
authors.affiliation: Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Charles LokHui
authors.initials: CL
authors.lastname: Tie
authors.affiliation: Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: EngWei
authors.initials: E
authors.lastname: Tang
authors.affiliation: Southern DHB, Dunedin, New Zealand.
authors.forename: Blair
authors.initials: B
authors.lastname: Bermingham
authors.affiliation: Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Cheuk-Kit
authors.initials: CK
authors.lastname: Wong
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality* / Q000523:psychology*; D000368:Aged; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016019:Survival Analysis
keywords: 6-year mortality; Acute coronary syndrome; Depression