| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
ORIGINAL ARTICLES |
From the Department of Psychiatry (K.I.K., P.d.J., R.H.S.v.d.B., J.K.) and Department of Internal Medicine (P.d.J.), University Medical Center Groningen, University of Groningen, The Netherlands.
Address correspondence and reprint requests to Peter de Jonge, PhD, Oostersingel 59, P.O. Box 30001, Groningen, 9700 RB Netherlands. E-mail: p.de.jonge{at}med.umcg.nl
Objective: The presence of depressive symptoms after myocardial infarction (MI) is a risk factor for new cardiovascular events. The importance of the course of post-MI depressive symptoms for cardiac prognosis is not clear. We therefore set out to investigate whether different courses of post-MI depressive symptoms can be identified and determine their associations with cardiac events.
Methods: Data were derived from the Depression after Myocardial Infarction (DepreMI) study, a naturalistic follow-up study of patients admitted for an MI in four hospitals in the Netherlands (N = 475). Scores on the Beck Depression Inventory (BDI) during hospitalization and at 3, 6, and 12 months post-MI were analyzed. Using latent class analysis (LCA), we identified classes characterized by distinctive courses of depressive symptoms and then examined their link to cardiac prognosis.
Results: The prevalence of significant depressive symptoms ranged from 22.7% to 25.5% throughout the post-MI year. Five distinct courses were found: no depressive symptoms (56.4%), mild depressive symptoms (25.7%), moderate and increasing depressive symptoms (9.3%), significant but decreasing depressive symptoms (4.6%), and significant and increasing depressive symptoms (4.0%). Subjects in this last class had, statistically, a significantly higher risk for a new cardiovascular event compared with subjects without depressive symptoms (hazard ratio (HR) = 2.73; p = .01). Controlling for baseline cardiac status and sociodemographic data did not alter the association (HR = 2.46; p = .03).
Conclusions: Post-MI depressed subjects with significant and increasing depressive symptoms are at particular risk of new cardiac events. This subgroup may be most suited for evaluation of the effects of antidepressant treatment on cardiac prognosis.
Key Words: depression • myocardial infarction
Abbreviations: BDI = Beck Depression Inventory; BIC = Bayesian Information Criteria; CABG = coronary artery bypass graft; CIDI = Composite International Diagnostic Interview; DepreMI = Depression after Myocardial Infarction; HR = hazard ratio; ICD-10 = International Classification of Diseases, Version 10; LCA = latent class analysis; LVEF = left ventricular ejection fraction; MI = myocardial infarction; PTCA = percutaneous transluminal coronary angioplasty.
This article has been cited by other articles:
 |
|
 |
|
  A. H. Glassman, J. T. Bigger Jr, and M. Gaffney Psychiatric Characteristics Associated With Long-term Mortality Among 361 Patients Having an Acute Coronary Syndrome and Major Depression: Seven-Year Follow-up of SADHART Participants Arch Gen Psychiatry, September 1, 2009; 66(9): 1022 - 1029. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Post-Myocardial Infarction Depression Clinical Pra AAFP Guideline for the Detection and Management of Post-Myocardial Infarction Depression Ann. Fam. Med, January 1, 2009; 7(1): 71 - 79. [Full Text] [PDF]
|
|
|
|
 |
|
 L. Stafford, H. J. Jackson, and M. Berk Cognitive-Personality Style as Vulnerability to Depression in Patients With Coronary Artery Disease: Roles of Sociotropy and Autonomy Psychosom Med, January 1, 2009; 71(1): 63 - 69. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. C. Huffman, F. A. Smith, M. A. Blais, A. M. Taylor, J. L. Januzzi, and G. L. Fricchione Pre-Existing Major Depression Predicts In-Hospital Cardiac Complications After Acute Myocardial Infarction Psychosomatics, July 1, 2008; 49(4): 309 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. de Jonge and J. Ormel Heterogeneity of Patients With Coronary Artery Disease and Distress and the Need to Identify Relevant Subtypes Arch Gen Psychiatry, July 1, 2008; 65(7): 851 - 852. [Full Text] [PDF]
|
|
|
|
 |
|
 B-J Hahm, Y-W Shin, E-J Shim, H J Jeon, J-M Seo, H Chung, and H G Yu Depression and the vision-related quality of life in patients with retinitis pigmentosa Br J Ophthalmol, May 1, 2008; 92(5): 650 - 654. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Pedersen, O. R. F. Smith, J. D. Vries, A. Appels, and J. Denollet Course of Anxiety Symptoms Over an 18-Month Period in Exhausted Patients Post Percutaneous Coronary Intervention Psychosom Med, April 1, 2008; 70(3): 349 - 355. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Thombs, K. Parakh, and R. C. Ziegelstein Throw the Window Out the Door J. Am. Coll. Cardiol., October 9, 2007; 50(15): 1519 - 1520. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Miaskowski, B. E. Aouizerat, M. Dodd, and B. Cooper Conceptual Issues in Symptom Clusters Research and Their Implications for Quality-of-Life Assessment in Patients With Cancer J Natl Cancer Inst Monographs, October 1, 2007; 2007(37): 39 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. de Jonge, A. Honig, J. P. van Melle, A. H. Schene, A. M.G. Kuyper, D. Tulner, A. Schins, J. Ormel, and The MIND-IT Investigators Nonresponse to Treatment for Depression Following Myocardial Infarction: Association With Subsequent Cardiac Events Am J Psychiatry, September 1, 2007; 164(9): 1371 - 1378. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. C Huffman Significant and increasing depressive symptoms are associated with increased risk of new cardiac events in people with a heart attack in the previous year Evid. Based Ment. Health, May 1, 2007; 10(2): 42 - 42. [Full Text] [PDF]
|
|
|
|
|
|
R. C. Ziegelstein, B. D. Thombs, K. Parakh, D. E. Stewart, S. E. Abbey, and S. L. Grace The Brain and the Heart: Independent or Interactive? J. Am. Coll. Cardiol., May 1, 2007; 49(17): 1824 - 1824. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
