TY - JOUR
T1 - Depression as a risk factor for mortality after acute myocardial infarction
AU - Carney, Robert M.
AU - Blumenthal, James A.
AU - Catellier, Diane
AU - Freedland, Kenneth E.
AU - Berkman, Lisa F.
AU - Watkins, Lana L.
AU - Czajkowski, Susan M.
AU - Hayano, Junichiro
AU - Jaffe, Allan S.
N1 - Funding Information:
This study was supported in part by grant 1UO-1HL58946 and contracts NO1-HC-55140, NO1-HC-55142, NO1-HC-55146, and NO1-HC-55148 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
PY - 2003/12/1
Y1 - 2003/12/1
N2 - The ENRICHD clinical trial, which compared an intervention for depression and social isolation to usual care, failed to decrease the rate of mortality and recurrent acute myocardial infarction (AMI) in post-AMI patients. One explanation for this is that depression was not associated with increased mortality in these patients. The purpose of this study was to determine if depression was associated with an increased risk of mortality in a subsample of the ENRICHD trial's depressed patients compared with a group of nondepressed patients recruited for an ancillary study. Three hundred fifty-eight depressed patients with an acute AMI from the ENRICHD clinical trial and 408 nondepressed patients who met the ENRICHD medical inclusion criteria were followed for up to 30 months. There were 47 deaths (6.1%) and 57 nonfatal AMIs (7.4%). After adjusting for other risk factors, depressed patients were at higher risk for all-cause mortality (hazard ratio 2.4, 95% confidence interval 1.2 to 4.7) but not for nonfatal recurrent infarction (hazard ratio 1.2, 95% confidence interval 0.7 to 2.0) compared with nondepressed patients. In conclusion, depression was an independent risk factor for death after AMI, but it did not have a significant effect on mortality until nearly 12 months after the acute event, nor did it predict nonfatal recurrent infarction.
AB - The ENRICHD clinical trial, which compared an intervention for depression and social isolation to usual care, failed to decrease the rate of mortality and recurrent acute myocardial infarction (AMI) in post-AMI patients. One explanation for this is that depression was not associated with increased mortality in these patients. The purpose of this study was to determine if depression was associated with an increased risk of mortality in a subsample of the ENRICHD trial's depressed patients compared with a group of nondepressed patients recruited for an ancillary study. Three hundred fifty-eight depressed patients with an acute AMI from the ENRICHD clinical trial and 408 nondepressed patients who met the ENRICHD medical inclusion criteria were followed for up to 30 months. There were 47 deaths (6.1%) and 57 nonfatal AMIs (7.4%). After adjusting for other risk factors, depressed patients were at higher risk for all-cause mortality (hazard ratio 2.4, 95% confidence interval 1.2 to 4.7) but not for nonfatal recurrent infarction (hazard ratio 1.2, 95% confidence interval 0.7 to 2.0) compared with nondepressed patients. In conclusion, depression was an independent risk factor for death after AMI, but it did not have a significant effect on mortality until nearly 12 months after the acute event, nor did it predict nonfatal recurrent infarction.
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U2 - 10.1016/j.amjcard.2003.08.007
DO - 10.1016/j.amjcard.2003.08.007
M3 - Article
C2 - 14636903
AN - SCOPUS:0242488856
SN - 0002-9149
VL - 92
SP - 1277
EP - 1281
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -