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Impact of pre-admission depression on mortality following myocardial infarction

Jens Sundbøll1, Morten Schmidt2, Kasper Adelborg2

  • 1Jens Sundbøll, MD, Morten Schmidt, MD, PhD, Kasper Adelborg, MD, Department of Clinical Epidemiology and Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Lars Pedersen, PhD, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Hans Erik Bøtker, MD, PhD, DMSci, Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark; Poul Videbech, MD, DMSci, Psychiatric Centre Glostrup, Glostrup, Denmark; Henrik Toft Sørensen, MD, PhD, DMSci, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark jens.sundboll@clin.au.dk.

The British Journal of Psychiatry : the Journal of Mental Science
|March 4, 2017
PubMed

Insights

A history of depression is linked to increased mortality risk after myocardial infarction (MI). This study found a 11% higher mortality rate in MI patients with prior depression.

Area of Science:

  • Cardiology
  • Psychiatry
  • Epidemiology

Background:

  • The prognostic significance of prior depression in myocardial infarction (MI) survivors is not well-established.
  • Understanding this association is crucial for improving post-MI patient outcomes.

Purpose of the Study:

  • To investigate the relationship between a history of depression and all-cause mortality in patients following a first-time myocardial infarction.
  • To quantify the mortality risk associated with depression in this patient population.

Main Methods:

  • A nationwide population-based cohort study utilizing Danish medical registries from 1995-2014.
  • Inclusion of all patients diagnosed with their first myocardial infarction.
  • Definition of previous depression included diagnosis or antidepressant use; Cox regression analysis was employed to calculate adjusted mortality rate ratios (aMRRs).

Main Results:

  • The study identified 170,771 patients with first-time myocardial infarction.
  • Patients with a history of depression exhibited significantly higher 19-year mortality risks (87% vs. 78%).
  • The adjusted mortality rate ratio (aMRR) was 1.11, increasing to 1.22 when antidepressant use was included in the depression definition.

Conclusions:

  • A history of depression is associated with a moderately elevated risk of all-cause mortality after myocardial infarction.
  • These findings highlight the importance of considering mental health in the management of cardiovascular disease.
  • Further research may explore mechanisms linking depression and cardiovascular outcomes.

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