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Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis.

Abstract

OBJECTIVE

To assess the association of depression following myocardial infarction (MI) and cardiovascular prognosis.

METHODS

The authors performed a meta-analysis of references derived from MEDLINE, EMBASE, and PSYCINFO (1975-2003) combined with crossreferencing without language restrictions. The authors selected prospective studies that determined the association of depression with the cardiovascular outcome of MI patients, defined as mortality and cardiovascular events within 2 years from index MI. Depression had to be assessed within 3 months after MI using established psychiatric instruments. A quality assessment was performed.

RESULTS

Twenty-two papers met the selection criteria. These studies described follow up (on average, 13.7 months) of 6367 MI patients (16 cohorts). Post-MI depression was significantly associated with all-cause mortality (odds ratio [OR], fixed 2.38; 95% confidence interval [CI], 1.76-3.22; p <.00001) and cardiac mortality (OR fixed, 2.59; 95% CI, 1.77-3.77; p <.00001). Depressive MI patients were also at risk for new cardiovascular events (OR random, 1.95; 95% CI, 1.33-2.85; p = .0006). Secondary analyses showed no significant effects of follow-up duration (0-6 months or longer) or assessment of depression (self-report questionnaire vs. interview). However, the year of data collection (before or after 1992) tended to influence the effect of depression on mortality (p = .08), with stronger associations found in the earlier studies (OR, 3.22; 95% CI, 2.14-4.86) compared with the later studies (OR, 2.01; 95% CI, 1.45-2.78).

CONCLUSIONS

Post-MI depression is associated with a 2- to 2.5-fold increased risk of impaired cardiovascular outcome. The association of depression with cardiac mortality or all-cause mortality was more pronounced in the older studies (OR, 3.22 before 1992) than in the more recent studies (OR, 2.01 after 1992).

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  • Authors+Show Affiliations

    ,

    Department of Cardiology, Thoraxcenter, University Hospital Groningen, P.O. Box 30.001, 9700 RB, The Netherlands. j.p.van.melle@thorax.azg.nl

    , , , , , ,

    Source

    Psychosomatic medicine 66:6 pg 814-22

    MeSH

    Cardiovascular Diseases
    Cause of Death
    Cohort Studies
    Comorbidity
    Cross-Cultural Comparison
    Depressive Disorder
    Female
    Humans
    Male
    Middle Aged
    Multicenter Studies as Topic
    Myocardial Infarction
    Personality Inventory
    Prognosis
    Prospective Studies
    Psychiatric Status Rating Scales

    Pub Type(s)

    Comparative Study
    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15564344

    Citation

    van Melle, Joost P., et al. "Prognostic Association of Depression Following Myocardial Infarction With Mortality and Cardiovascular Events: a Meta-analysis." Psychosomatic Medicine, vol. 66, no. 6, 2004, pp. 814-22.
    van Melle JP, de Jonge P, Spijkerman TA, et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med. 2004;66(6):814-22.
    van Melle, J. P., de Jonge, P., Spijkerman, T. A., Tijssen, J. G., Ormel, J., van Veldhuisen, D. J., ... van den Berg, M. P. (2004). Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosomatic Medicine, 66(6), pp. 814-22.
    van Melle JP, et al. Prognostic Association of Depression Following Myocardial Infarction With Mortality and Cardiovascular Events: a Meta-analysis. Psychosom Med. 2004;66(6):814-22. PubMed PMID: 15564344.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. AU - van Melle,Joost P, AU - de Jonge,Peter, AU - Spijkerman,Titia A, AU - Tijssen,Jan G P, AU - Ormel,Johan, AU - van Veldhuisen,Dirk J, AU - van den Brink,Rob H S, AU - van den Berg,Maarten P, PY - 2004/11/27/pubmed PY - 2005/9/1/medline PY - 2004/11/27/entrez SP - 814 EP - 22 JF - Psychosomatic medicine JO - Psychosom Med VL - 66 IS - 6 N2 - OBJECTIVE: To assess the association of depression following myocardial infarction (MI) and cardiovascular prognosis. METHODS: The authors performed a meta-analysis of references derived from MEDLINE, EMBASE, and PSYCINFO (1975-2003) combined with crossreferencing without language restrictions. The authors selected prospective studies that determined the association of depression with the cardiovascular outcome of MI patients, defined as mortality and cardiovascular events within 2 years from index MI. Depression had to be assessed within 3 months after MI using established psychiatric instruments. A quality assessment was performed. RESULTS: Twenty-two papers met the selection criteria. These studies described follow up (on average, 13.7 months) of 6367 MI patients (16 cohorts). Post-MI depression was significantly associated with all-cause mortality (odds ratio [OR], fixed 2.38; 95% confidence interval [CI], 1.76-3.22; p <.00001) and cardiac mortality (OR fixed, 2.59; 95% CI, 1.77-3.77; p <.00001). Depressive MI patients were also at risk for new cardiovascular events (OR random, 1.95; 95% CI, 1.33-2.85; p = .0006). Secondary analyses showed no significant effects of follow-up duration (0-6 months or longer) or assessment of depression (self-report questionnaire vs. interview). However, the year of data collection (before or after 1992) tended to influence the effect of depression on mortality (p = .08), with stronger associations found in the earlier studies (OR, 3.22; 95% CI, 2.14-4.86) compared with the later studies (OR, 2.01; 95% CI, 1.45-2.78). CONCLUSIONS: Post-MI depression is associated with a 2- to 2.5-fold increased risk of impaired cardiovascular outcome. The association of depression with cardiac mortality or all-cause mortality was more pronounced in the older studies (OR, 3.22 before 1992) than in the more recent studies (OR, 2.01 after 1992). SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/15564344/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=15564344 DB - PRIME DP - Unbound Medicine ER -