title: Depressive symptoms, functional measures and long-term outcomes of high-risk ST-elevated myocardial infarction patients treated by primary angioplasty.
abstract: The presence of major depressive symptoms is usually considered a negative long-term prognostic factor after an acute myocardial infarction (AMI); however, most of the supporting research was conducted before the era of immediate reperfusion by percutaneous coronary intervention. The aims of this study are to evaluate if depression still retains long-term prognostic significance in our era of immediate coronary reperfusion, and to study possible correlations with clinical parameters of physical performance. In 184 patients with recent ST-elevated AMI (STEMI), treated by immediate reperfusion, moderate or severe depressive symptoms (evaluated by Beck Depression Inventory version I) were present in 10 % of cases. Physical performance was evaluated by two 6-min walk tests and by a symptom-limited cardiopulmonary exercise test: somatic/affective (but not cognitive/affective) symptoms of depression and perceived quality of life (evaluated by the EuroQoL questionnaire) are worse in patients with lower levels of physical performance. Follow-up was performed after a median of 29 months by means of telephone interviews; 32 major adverse cardiovascular events (MACE) occurred. The presence of three vessels disease and low left ventricle ejection fraction are correlated with a greater incidence of MACE; only somatic/affective (but not cognitive/affective) symptoms of depression correlate with long-term outcomes. In patients with recent STEMI treated by immediate reperfusion, somatic/affective but not cognitive/affective symptoms of depression show prognostic value on long-term MACE. Depression symptoms are not predictors "per se" of adverse prognosis, but seem to express an underlying worse cardiac efficiency, clinically reflected by poorer physical performance.
authors.affiliation: Preventive Cardiology and Rehabilitation, Inst. Codivilla-Putti, Via Codivilla, 1, 32043, Cortina d'Ampezzo, BL, Italy. l.compostella@alice.it.|Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy. l.compostella@alice.it.
authors.forename: Leonida
authors.initials: L
authors.lastname: Compostella
authors.affiliation: Preventive Cardiology and Rehabilitation, Inst. Codivilla-Putti, Via Codivilla, 1, 32043, Cortina d'Ampezzo, BL, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Lorenzi
authors.affiliation: Preventive Cardiology and Rehabilitation, Inst. Codivilla-Putti, Via Codivilla, 1, 32043, Cortina d'Ampezzo, BL, Italy.|Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Russo
authors.affiliation: Preventive Cardiology and Rehabilitation, Inst. Codivilla-Putti, Via Codivilla, 1, 32043, Cortina d'Ampezzo, BL, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Setzu
authors.affiliation: Department of Medicine, School of Emergency Medicine, University of Padua, Padova, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Compostella
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy.
authors.forename: Elia
authors.initials: E
authors.lastname: Vettore
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy.
authors.forename: Giambattista
authors.initials: G
authors.lastname: Isabella
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy.
authors.forename: Sabino
authors.initials: S
authors.lastname: Iliceto
authors.affiliation: Preventive Cardiology and Rehabilitation, Inst. Codivilla-Putti, Via Codivilla, 1, 32043, Cortina d'Ampezzo, BL, Italy.|Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padova, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Bellotto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression / Q000150:complications* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D057566:Self Report; D011795:Surveys and Questionnaires; D013995:Time
keywords: Beck inventory; Depression; Myocardial infarction; Physical fitness; Prognosis