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Updated: Jan 25, 2026
Acute Myocardial Infarction in Rats
Published on: February 16, 2011
Is depression a real risk factor for acute myocardial infarction mortality? A retrospective cohort study
Silvia Cocchio1, Tatjana Baldovin1, Patrizia Furlan1
1Department of Cardiac Thoracic Vascular Sciences and Public Health, Public Health Section, University of Padua, Via Loredan, 18, 35121, Padova, Italy.
Insights
Patients using antidepressants (ADs) before acute myocardial infarction (AMI) face higher mortality risks. This study highlights the importance of monitoring depression in cardiac patients for better outcomes.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Depression is linked to increased cardiovascular event risk and mortality, especially with comorbidities.
- Antidepressant (AD) use is a proxy for depression status.
- The association between pre-acute myocardial infarction (AMI) antidepressant use and post-AMI mortality requires investigation.
Purpose of the Study:
- To determine if continuous antidepressant use prior to AMI is associated with increased mortality after the event.
- To assess the impact of antidepressant use on mortality outcomes in AMI patients.
Main Methods:
- Retrospective cohort study using hospital discharge and mortality records (2002-2015) in the Veneto Region.
- Identification of antidepressant users through drug purchase records.
- Survival analysis using Kaplan-Meier and Cox regression models, adjusting for confounders.
Main Results:
- Among 3985 AMI patients, 349 (8.8%) were classified as AD users.
- Overall 30-day mortality post-AMI was 13.1%.
- Antidepressant use was independently associated with higher mortality (adj OR = 1.75, 95% CI: 1.40-2.19) after adjusting for confounders.
Conclusions:
- Antidepressant users hospitalized for AMI exhibit a poorer prognosis regarding mortality.
- Routinely available health records can efficiently monitor subpopulations.
- Early identification of AMI survivors with a history of antidepressant use is crucial for targeted monitoring.
Background:
Depression has been associated with a higher risk of cardiovascular events and a higher mortality in patients with one or more comorbidities. This study investigated whether continuative use of antidepressants (ADs), considered as a proxy of a state of depression, prior to acute myocardial infarction (AMI) is associated with a higher mortality afterwards. The outcome to assess was mortality by AD use.
Methods:
A retrospective cohort study was conducted in the Veneto Region on hospital discharge records with a primary diagnosis of AMI in 2002-2015. Subsequent deaths were ascertained from mortality records. Drug purchases were used to identify AD users. A descriptive analysis was conducted on patients' demographics and clinical data. Survival after discharge was assessed with a Kaplan-Meier survival analysis and Cox's multiple regression model.
Results:
Among 3985 hospital discharge records considered, 349 (8.8%) patients were classified as 'AD users'. The mean AMI-related hospitalization rate was 164.8/100,000 population/year, and declined significantly from 204.9 in 2002 to 130.0 in 2015, but only for AD users (- 40.4%). The mean overall follow-up was 4.6 ± 4.1 years. Overall, 523 patients (13.1%) died within 30 days of their AMI. The remainder survived a mean 5.3 ± 4.0 years. After adjusting for potential confounders, use of antidepressants was independently associated with mortality (adj OR = 1.75, 95% CI: 1.40-2.19).
Conclusions:
Our findings show that AD users hospitalized for AMI have a worse prognosis in terms of mortality. The use of routinely-available records can prove an efficient way to monitor trends in the state of health of specific subpopulations, enabling the early identification of AMI survivors with a history of antidepressant use.
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