Depressive symptoms and health-related quality of life following acute myocardial infarction

Background Depression and impaired health-related quality of life are common after acute myocardial infarction (AMI) and have been associated with worse clinical and functional outcomes. However, local data describing these dimensions during the post-infarction period in public healthcare settings remain limited. Methods We conducted a cross-sectional observational study using data from the Prospective Myocardial Infarction Registry (REPRIM), including patients with ST-segment elevation myocardial infarction (STEMI) treated in a public tertiary care setting in Chile between 2019 and 2020. Health-related quality of life was assessed 30 days after the index event using the SF-36 questionnaire, and depressive symptoms were evaluated with the 17-item Hamilton Depression Rating Scale (HAM-D). Associations between quality of life and depressive symptoms were explored using multivariable linear regression models adjusted for age, sex, diabetes mellitus, hypertension and left ventricular ejection fraction, and mortality was described during the available follow-up. Results During the study period, 121 patients with acute myocardial infarction were identified. Of the 100 patients included in REPRIM, 68 met the criteria for this subanalysis (alive at 30 days, successful contact and complete questionnaire data). Most patients exhibited at least mild depressive symptoms (94.1%), with a median HAM-D score of 12 (interquartile range 10–15). Higher depressive symptom severity was significantly associated with lower physical (PCS) and mental (MCS) component scores of the SF-36 in unadjusted analyses ( ρ = −0.46 and ρ = −0.58, respectively; p < 0.001) and remained independently associated after multivariable adjustment [ β = −1.26 [95% CI −2.06 to −0.46] for PCS; β = −1.50 [95% CI −2.40 to −0.61] for MCS; both p < 0.01]. Patients with moderate or higher depressive symptoms had significantly worse quality-of-life scores compared with those with mild symptoms. Mortality analyses were descriptive due to the limited number of events. Conclusions In this cross-sectional study of STEMI survivors treated in a public hospital, depressive symptoms were highly prevalent at 30 days and were consistently associated with poorer physical and mental health-related quality of life. These findings highlight the substantial burden of depressive symptoms early after myocardial infarction and support the relevance of integrating mental health and quality-of-life assessment into post-infarction follow-up within public healthcare systems, while acknowledging the limitations of our small, single-centre study.