Association of Depression with adverse outcomes in Patients with Myocardial Infarction with Non-obstructive Coronary Arteries (MINOCA)

Background: Depression has a significant relationship with cardiovascular diseases. But evidence is scarce regarding its impact on adverse outcome in patients of non-obstructive coronary artery disease. Aim: To assess the association of depression with adverse outcome in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA). Methods: This cohort study was conducted in the Department of Cardiology, Punjab Institute of Cardiology, Lahore for 12 months i.e. July 2017 to June 2018. 260 patients; 130 in exposed group and 130 in unexposed group fulfilling selection criteria were enrolled for the study with or without depression. Patients were then evaluated for adverse outcome. SPSS v. 25 was used to analyse the data. Results: The mean age of exposed group was 42.85±9.33 years and the mean age of unexposed group was 52.52± 8.18 years. There were 49(37.7%) males and 81(62.3%) females in exposed group with the male-to-female ratio was 1: 1.7, while in unexposed group there were 55(42.3%) males and 75(57.7%) females with the male-to-female ratio was 1: 1.4. ST-segment elevation was observed in 31(23.8%) exposed patients while in 27(20.8%) unexposed patients. In exposed group, cardiovascular events were noted in 44(33.8%) patients, while in 27(20.8%) patients in unexposed group (OR=1.362, 95% CI; 1.071, 1.731, P=0.018). In exposed group, cardiovascular related mortality were noted in 38(29.2%) patients, while in 17(13.1%) patients in unexposed group (OR=1.54, 95% CI; 1.22, 1.943, P = 0.001). In exposed group, all-cause mortality were noted in 19 (14.6%) patients, while in 9 (6.9%) patients in unexposed group (OR=1.418, 95% CI; 1.063, 1.892, p=0.045). Conclusions: Our study results showed that depression in patients having MINOCA is significantly related to adverse cardiovascular sequel and leads to more severe sequel.