Transient, new, and persistent depressive symptoms after MI were associated with increased 6-month rehospitalization or mortality (HRs 1.34, 1.71, and 1.42, respectively; all P<0.05).
Cohort (n=1,873)
Does transient, new, or persistent depression worsen clinical and patient-reported outcomes in patients recovering from acute myocardial infarction?
Any depressive symptoms in the first month after an acute myocardial infarction, whether transient, new, or persistent, are associated with significantly increased risks of mortality, rehospitalization, and worse health status at 6 months.
Effect estimate: HR 1.34, 1.71, and 1.42
p-value: p=<.05
BACKGROUND: Depression predicts worse outcomes after myocardial infarction (MI), but whether its time course in the month following MI has prognostic importance is unknown. Our objective was to evaluate the prognostic importance of transient, new, or persistent depression on outcomes at 6 months after MI. METHODS: In a prospective registry of acute MI (Prospective Registry Evaluating outcomes after Myocardial Infarction: Events and Recovery PREMIER), depressive symptoms were measured in 1873 patients with the Patient Health Questionnaire (PHQ) during hospitalization and 1 month after discharge and were classified as transient (only at baseline), new (only at 1 month), or persistent (at both times). Outcomes at 6 months included (1) all-cause rehospitalization or mortality and (2) health status (angina, physical limitation, and quality of life using the Seattle Angina Questionnaire). RESULTS: Compared with nondepressed patients, all categories of depression were associated with higher rehospitalization or mortality rates, more frequent angina, more physical limitations, and worse quality of life. The adjusted hazard ratios for rehospitalization or mortality were 1.34, 1.71, and 1.42 for transient, new, and persistent depression, respectively (all P<.05). Corresponding odds ratios were 1.62, 2.73, and 2.64 (all P<.01) for angina and 1.69, 2.25, and 3.27 (all P<.05) for physical limitation. Depressive symptoms showed a stronger association with health status compared with traditional measures of disease severity. CONCLUSION: Depressive symptoms after MI, irrespective of whether they persist, subside, or newly develop in the first month after hospitalization, are associated with worse outcomes after MI.
Susmita Parashar (2006) conducted a cohort in Acute myocardial infarction (n=1,873). Depressive symptoms (transient, new, or persistent) vs. Nondepressed patients was evaluated on All-cause rehospitalization or mortality (HR 1.34, 1.71, and 1.42, p=<.05). Transient, new, and persistent depressive symptoms after MI were associated with increased 6-month rehospitalization or mortality (HRs 1.34, 1.71, and 1.42, respectively; all P<0.05).