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Depression and myocardial injury in ST-segment elevation myocardial infarction: A cardiac magnetic resonance imaging
Zhao-Qing Sun1, Tong-Tong Yu1, Yue Ma2
1Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.
Insights
Depression is linked to larger heart damage in ST-elevation myocardial infarction (STEMI) patients. This study found that higher depression scores correlate with increased myocardial injury after percutaneous coronary intervention.
Area of Science:
- Cardiology
- Psychiatry
- Medical Imaging
Background:
- Depression is prevalent in myocardial infarction (MI) patients and linked to worse outcomes.
- The relationship between depression and myocardial injury in ST-elevation myocardial infarction (STEMI) using cardiac magnetic resonance (CMR) is not well understood.
Purpose of the Study:
- To investigate the association between depression and myocardial injury assessed by CMR in STEMI patients.
Main Methods:
- Prospective cohort study of 107 STEMI patients undergoing primary percutaneous coronary intervention (P-PCI).
- Depressive symptoms assessed using the Patient Health Questionnaire-9 (PHQ-9).
- Myocardial injury quantified by CMR at a median of 3 days post-P-PCI.
Main Results:
- Major depression (PHQ-9 ≥ 10) was diagnosed in 17.8% of patients.
- After multivariable adjustment, major depression was significantly associated with larger infarction size (OR: 4.840, P=0.034).
- Increased PHQ-9 scores, as a continuous variable, were independently associated with a higher risk of large infarction size (OR: 1.226, P=0.003).
Conclusions:
- Depression is an independent predictor of large infarction size in STEMI patients treated with P-PCI.
- Findings highlight the importance of assessing and managing depression in STEMI patients to potentially mitigate myocardial injury.
Background:
Depression is common in patients with myocardial infarction and has been independently associated with adverse outcomes. However, the association between depression and myocardial injury on cardiac magnetic resonance (CMR) in patients with ST-segment elevation myocardial infarction (STEMI) has still not been assessed.
Aim:
To assess the association between depression and myocardial injury on CMR in patients with STEMI.
Methods:
A total of 107 STEMI patients undergoing primary percutaneous coronary intervention (P-PCI) were analyzed in this prospectivecohort study. Each subject completed the Patient Health Questionnaire-9 (PHQ-9) to assess the presence and severity of depressive symptoms. CMR was performed at a median of 3 d after P-PCI for quantifying post-MI myocardial injury. Correlations between depression identified by the PHQ-9 and myocardial injury measured on CMR were assessed.
Results:
In this study, 19 patients (17.8%) were diagnosed with major depression identified by the PHQ-9 ≥ 10. PHQ-9 was analyzed both as a continuous variable and dichotomous variable. After multivariable adjustment, the proportion of patients with large infarction size was significantly higher in the major depression group (PHQ-9 ≥ 10) (OR: 4.840, 95%CI: 1.122-20.868, P =0.034). When the PHQ-9 was evaluated as a continuous variable, after multivariable adjustment, an increased PHQ-9 score was associated with an increased risk of large infarction size (OR: 1.226, 95%CI: 1.073-1.401, P =0.003).
Conclusion:
In patients with STEMI undergoing PCI, depression was independently associated with a large infarction size.
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