title: Depression following acute coronary syndrome: a Danish nationwide study of potential risk factors.
abstract: Depression is common following acute coronary syndrome, and thus, it is important to provide knowledge to improve prevention and detection of depression in this patient group. The objectives of this study were to examine: (1) whether indicators of stressors and coping resources were risk factors for developing depression early and later after an acute coronary syndrome and (2) whether prior depression modified these associations.
  
  
  
  The study was a register-based cohort study, which includes 87,118 patients with a first time diagnosis of acute coronary syndrome during the period 2001-2009 in Denmark. Cox regression models were used to analyse hazard ratios (HRs) for depression.
  
  
  
  1.5 and 9.5 % develop early (≤30 days) and later (31 days-2 years) depression after the acute coronary syndrome. Among all patients with depression, 69.2 % had first onset depression, while 30.8 % developed a recurrent depression. Most patient characteristics (demographic factors, socioeconomic status, psychosocial factors, health-related behavioural factors, somatic comorbidities, and severity of acute coronary syndrome) were significantly associated with increased HRs for both early and later depressions. Prior depression modified most of these associations in such a way that the association was attenuated in patients with a prior depression.
  
  
  
  Our results indicate that first time and recurrent depression following acute coronary syndrome have different risk profiles. This is important knowledge that may be used to focus future interventions for prevention and detection.
authors.affiliation: Research Centre for Prevention and Health, Rigshospitalet Glostrup Hospital, Nordre ringvej 57, 2600, Glostrup, Denmark. tshj@sund.ku.dk.|Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. tshj@sund.ku.dk.
authors.forename: Terese Sara Hoej
authors.identifier: 0000-0003-1450-4472
authors.initials: TS
authors.lastname: Joergensen
authors.affiliation: Research Centre for Prevention and Health, Rigshospitalet Glostrup Hospital, Nordre ringvej 57, 2600, Glostrup, Denmark.|Competence Centre for Dual Diagnosis, Psychiatric Centre Sct. Hans, Roskilde, Denmark.
authors.forename: Solvej
authors.initials: S
authors.lastname: Maartensson
authors.affiliation: Research Centre for Prevention and Health, Rigshospitalet Glostrup Hospital, Nordre ringvej 57, 2600, Glostrup, Denmark.
authors.forename: Else Helene
authors.initials: EH
authors.lastname: Ibfelt
authors.affiliation: Department of Psychiatry O, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors.forename: Martin Balslev
authors.initials: MB
authors.lastname: Joergensen
authors.affiliation: Research Centre for Prevention and Health, Rigshospitalet Glostrup Hospital, Nordre ringvej 57, 2600, Glostrup, Denmark.|Psychiatric Center Ballerup, Ballerup, Denmark.
authors.forename: Ida Kim
authors.initials: IK
authors.lastname: Wium-Andersen
authors.affiliation: Research Centre for Prevention and Health, Rigshospitalet Glostrup Hospital, Nordre ringvej 57, 2600, Glostrup, Denmark.|Department of Psychiatry, Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.
authors.forename: Marie Kim
authors.initials: MK
authors.lastname: Wium-Andersen
authors.affiliation: Department of Cardiology Y, Bispebjerg Hospital, Bispebjerg bakke 23, 2400, Copenhagen, Denmark.
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
authors.affiliation: Department of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.
authors.forename: Per Kragh
authors.initials: PK
authors.lastname: Andersen
authors.affiliation: Research Centre for Prevention and Health, Rigshospitalet Glostrup Hospital, Nordre ringvej 57, 2600, Glostrup, Denmark.
authors.forename: Merete
authors.initials: M
authors.lastname: Osler
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark; D003863:Depression / Q000209:etiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012042:Registries; D012307:Risk Factors
keywords: Acute coronary syndrome; Depression; Effect modification; Risk factors