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Depression predicts mortality and hospitalization in patients with myocardial infarction complicated by heart failure

John S Rumsfeld1, Philip G Jones, Mary A Whooley

  • 1Section of Cardiology, Denver VA Medical Center, Denver, Colorado 80220, USA. john.rumsfeld@med.va.gov

American Heart Journal
|November 18, 2005
PubMed

Insights

Depression independently predicts mortality and hospitalization in acute myocardial infarction (AMI) patients with heart failure. Early intervention for depression may improve outcomes in these high-risk individuals.

Area of Science:

  • Cardiology
  • Psychiatry
  • Clinical Research

Background:

  • Patients with acute myocardial infarction (AMI) and heart failure are at increased risk for adverse outcomes.
  • The role of depressive symptoms in predicting mortality and hospitalization in this population requires further investigation.

Purpose of the Study:

  • To determine if depressive symptoms are an independent predictor of mortality and hospitalization in patients with AMI complicated by heart failure.

Main Methods:

  • The EPHESUS trial enrolled patients with AMI and heart failure from Canada, UK, and US.
  • Depressive symptoms were assessed at baseline using the Medical Outcomes Study-Depression questionnaire.
  • Cox proportional hazards regression analysis was employed to evaluate the association between depressive symptoms and 2-year all-cause mortality and cardiovascular death or hospitalization, adjusting for clinical variables.

Main Results:

  • 22.6% of patients (143/634) reported significant depressive symptoms at baseline.
  • Depressed patients exhibited higher 2-year mortality (29% vs 18%, P = .004) and cardiovascular death or hospitalization (42% vs 33%, P = .016).
  • After risk adjustment, depressive symptoms remained significant predictors of mortality (HR 1.75, P = .01) and cardiovascular death or hospitalization (HR 1.41, P = .03).

Conclusions:

  • Depression is an independent predictor of mortality and hospitalization in patients post-AMI with heart failure.
  • Further research is warranted to explore the efficacy of depression interventions in improving survival and reducing hospitalizations in this patient group.
Abstract

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