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Treffer: Time course of depression and outcome of myocardial infarction.

Title:
Time course of depression and outcome of myocardial infarction.
Authors:
Parashar S; Divisions of General Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA. smallik@emory.edu, Rumsfeld JS, Spertus JA, Reid KJ, Wenger NK, Krumholz HM, Amin A, Weintraub WS, Lichtman J, Dawood N, Vaccarino V
Source:
Archives of internal medicine [Arch Intern Med] 2006 Oct 09; Vol. 166 (18), pp. 2035-43.
Publication Type:
Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
Language:
English
Journal Info:
Publisher: American Medical Assn Country of Publication: United States NLM ID: 0372440 Publication Model: Print Cited Medium: Print ISSN: 0003-9926 (Print) Linking ISSN: 00039926 NLM ISO Abbreviation: Arch Intern Med Subsets: MEDLINE
Imprint Name(s):
Original Publication: Chicago, American Medical Assn.
MeSH Terms:
Outcome Assessment, Health Care*, Depression/*epidemiology , Myocardial Infarction/*mortality, Activities of Daily Living ; Angina, Unstable/epidemiology ; Antidepressive Agents/therapeutic use ; Depression/drug therapy ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Patient Readmission/statistics & numerical data ; Prognosis ; Prospective Studies ; Quality of Life ; Registries ; Severity of Illness Index ; Surveys and Questionnaires ; Time Factors ; United States/epidemiology
Grant Information:
K01-DP000085-01 United States DP NCCDPHP CDC HHS; K12-RR17643 United States RR NCRR NIH HHS; K23-RR023171 United States RR NCRR NIH HHS; K24-HL077506 United States HL NHLBI NIH HHS; MO1-RR00039 United States RR NCRR NIH HHS; R01-AG026255 United States AG NIA NIH HHS; R01-HL68630 United States HL NHLBI NIH HHS
Substance Nomenclature:
0 (Antidepressive Agents)
Entry Date(s):
Date Created: 20061013 Date Completed: 20061109 Latest Revision: 20191210
Update Code:
20250114
DOI:
10.1001/archinte.166.18.2035
PMID:
17030839
Database:
MEDLINE

Weitere Informationen

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.