Depression, Myocardial Infarction, Cardiovascular, Patient Data
Background: The association between depression after myocardial infarction (post-MI) and increased risk of mortality and cardiac morbidity may be due to cardiac disease severity.
Aims: To combine original data from studies on the association between post-MI depression and prognosis into one database. To investigate to what extent post-MI depression predicts prognosis independently of disease severity.
Method: Individual patient data meta-analysis of studies, using multilevel, multivariable Cox regression analyses.
Results:Sixteen studies participated, creating a database of 10,175 post-MI patients. HRs for post-MI depression were 1.32 (95%CI 1.26-1.38, p
Conclusions: The association between post-MI depression and prognosis is attenuated after adjustment for cardiac disease severity. Still, depression remains independently associated with prognosis, with a 22% increased risk of all-cause mortality and a 13% increased risk of cardiovascular events per standard deviation in depression z-score.
Declaration of interest: None.
Meijer A, Conradi HJ, Bos EH, Anselmino M, Carney RM, Denollet J, Doyle F, Freedland KE, Grace SL, Hosseini SH, Lane DA, Pilote l, Parakh K, Rafanelli C, Sato H, Steeds RP, Welin C, de Jonge P. Adjusted prognostic association of post-myocardial infarction depression withmortality and cardiovascular events: an individual patient data meta-analysis. British Journal of Psychiatry. 2013;203:90-102.