Decreased impact of post-myocardial infarction depression on cardiac prognosis?

Spijkerman, Titia A.; van den Brink, Rob H.S.; May, Jo F.; Winter, Jobst B.; van Melle, Joost P.; de Jonge, Peter; Crijns, Harry J.G.M.; Ormel, Johan

doi:10.1016/j.jpsychores.2006.02.016

« Previous Next »Journal of Psychosomatic Research
Volume 61, Issue 4 , Pages 493-499, October 2006

Decreased impact of post-myocardial infarction depression on cardiac prognosis?

Titia A. Spijkerman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Rob H.S. van den Brink
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Corresponding author. Department of Psychiatry, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. Tel.: +31 50 3612089; fax: +31 50 3619722
Jo F. May
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Jobst B. Winter
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Joost P. van Melle
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Peter de Jonge
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Harry J.G.M. Crijns
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Johan Ormel
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

Received 6 May 2005; received in revised form 13 February 2006; accepted 16 February 2006.

Abstract

Objective

A recent meta-analysis suggests that the impact of post-myocardial infarction (MI) depression on cardiac prognosis has decreased over the last decade. We tested whether depression still significantly affects prognosis in the present health care situation.

Methods

Four hundred ninety-four MI patients were screened for depression. Patients with depression were compared with patients without on cardiovascular events (fatal or nonfatal) during an average follow-up of 2.5 years. Demographic characteristics and cardiac risk factors were controlled for.

Results

We found that depression was associated with the occurrence of cardiovascular events in both univariate [hazard ratio (HR), 1.84; 95% confidence interval, 1.24–2.72] and multivariate analysis (HR, 1.56; 1.02–2.38).

Conclusions

Depression still has an independent impact on cardiac prognosis after MI, but this influence is smaller than found in early studies. Improvements in general care for MI and better recognition and treatment of post-MI depression may have decreased the impact of depression on prognosis.

Keywords: Depression, Myocardial infarction, Cardiac prognosis, Cardiac events, Cardiac mortality, Risk factors