Key result
Severe depression symptoms 1 year after the onset of myocardial infarction significantly increased the risk of subsequent cardiovascular events in male patients (HR 1.67) compared to those with minimal symptoms.
Why the study?
Do depression symptoms 1 year after onset of myocardial infarction predict subsequent cardiovascular events in survivors?
Cohort (n=1,587)
Yes
Do depression symptoms 1 year after onset of myocardial infarction predict subsequent cardiovascular events in survivors?
Hazard Ratio: 1.67 (95% CI 1.01–2.77)
Absolute Event Rate: 10.4% vs 6.2%
p-value: p=0.04
Depression symptoms 1 year after myocardial infarction are a significant independent predictor of subsequent long-term cardiovascular events in male survivors.
May warrant depression screening 1 year post-MI in men; leaves open whether intervention reduces events.
BACKGROUND: The purpose of this study was to investigate the association between depression symptoms 1 year after onset and subsequent cardiovascular events among survivors of myocardial infarction (MI). METHODS AND RESULTS: The participants were recruited from respondents to a district-based survey known as the Osaka Acute Coronary Insufficiency Study. Of 4,271 eligible MI patients, 1,951 completed the Zung Self-Rating Depression Scale (SDS) at their 1-year follow-up examination. After excluding patients who experienced cardiovascular events within 1 year, the data for the remaining 1,307 male patients and 280 female patients were analyzed. Among male patients, depression status at 1 year after onset of MI was significantly related to risk of subsequent cardiovascular events throughout the follow-up period (median 2.9 years). The male patients in the top vs. bottom tertiles of SDS scores (top tertile being ≥42) had a multivariable-adjusted hazard ratio (HR) of 1.67 (95% confidence interval (CI) 1.01-2.77, P=0.04), and a 1-SD increment in SDS score was significantly related to a heightened risk of cardiovascular events, with a multivariable-adjusted HR of 1.30 (95%CI 1.07-1.58, P=0.01). There were no significant associations between SDS scores and cardiovascular events among female patients. CONCLUSIONS: Depression symptoms 1 year after onset of MI are a significant predictor of subsequent cardiovascular events for male patients.
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Shiozaki et al. (2011) conducted a cohort in Myocardial infarction (n=1,587). Depression symptoms (top tertile SDS score ≥42) vs. Minimal depression symptoms (bottom tertile SDS score ≤33) was evaluated on Subsequent cardiovascular events (HR 1.67, 95% CI 1.01-2.77, p=0.04). Severe depression symptoms 1 year after the onset of myocardial infarction significantly increased the risk of subsequent cardiovascular events in male patients (HR 1.67) compared to those with minimal symptoms.
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