Decreased impact of post-myocardial infarction depression on cardiac prognosis?
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.
aDepartment of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
bDepartment of Cardiology, 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
ABSTRACT