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Association Between Depression and Outcomes in Chinese Patients With Myocardial Infarction and Nonobstructive
Xiao-Hong Gu1, Chao-Jie He2, Liang Shen2
11 Department of Infectious Diseases and Department of Nursing First Affiliated Hospital of Jiaxing University Jiaxing Zhejiang China.
Insights
Depression diagnosis in patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) significantly increases the risk of death and cardiovascular events. This highlights the importance of addressing mental health in MINOCA patient care.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Myocardial infarction with nonobstructive coronary arteries (MINOCA) affects approximately 10% of myocardial infarction patients.
- Limited research exists on the impact of depression on MINOCA patient outcomes.
- This study investigates the link between depression and clinical outcomes in Chinese MINOCA patients.
Purpose of the Study:
- To examine the association between depression and clinical outcomes in Chinese patients diagnosed with MINOCA.
- To determine if depression is an independent prognostic factor for adverse events in MINOCA.
Main Methods:
- A prospective cohort study involving 633 MINOCA patients followed for 3 years.
- Depression diagnosis confirmed via psychiatric interview based on DSM-5 criteria.
- Outcomes assessed included all-cause mortality and cardiovascular events.
Main Results:
- Depression was significantly associated with increased all-cause mortality (log-rank P<0.001).
- Depression also showed a significant association with cardiovascular events (log-rank P<0.001).
- Newly diagnosed depression independently predicted higher mortality (aHR 7.250) and cardiovascular events (aHR 3.411).
Conclusions:
- A new diagnosis of depression at the time of myocardial infarction is linked to worse clinical outcomes in MINOCA patients.
- These findings underscore the prognostic significance of depression in the MINOCA population.
- Integrated care addressing both cardiac and mental health is crucial for MINOCA patients.
Abstract:
Background Myocardial infarction with nonobstructive coronary arteries ( MINOCA ) occurs in ≈10% of all patients with myocardial infarction. Studies on effects of depression on MINOCA outcomes are lacking. Therefore, the aim of this study was to examine the association of depression with clinical outcomes in Chinese patients with MINOCA . Methods and Results We conducted a prospective cohort study of 633 participants with MINOCA and followed up for 3 years. End points were defined as all-cause mortality and cardiovascular events. Diagnosis of depression was ascertained using the psychiatric interview based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). During the follow-up period, all-cause death occurred in 93 individuals and cardiovascular events developed in 170 individuals. Kaplan-Meier curves showed a significant association of depression with all-cause mortality (log-rank P<0.001) and cardiovascular events (log-rank P<0.001). Multiple Cox regression identified the new diagnosis of depression as an independent prognostic factor for all-cause mortality as well as cardiovascular events (adjusted hazard ratio, 7.250; 95% CI, 4.735-11.100; P<0.001; and hazard ratio, 3.411; 95% CI , 2.490-4.674; P<0.001, respectively). Conclusions The new diagnosis of depression at the time of myocardial infarction is associated with increased risk of adverse clinical outcomes in patients with MINOCA.
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