Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: Individual patient data meta-analysis

A. Meijer, H. J. Conradi, E. H. Bos, M. Anselmino, R. M. Carney, J. Denollet, F. Doyle, K. E. Freedland, S. L. Grace, S. H. Hosseini, D. A. Lane, L. Pilote, K. Parakh, C. Rafanelli, H. Sato, R. P. Steeds, C. Welin, P. De Jonge

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: The association between depression after myocardial infarction 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-infarction depression and prognosis into one database, and to investigate to what extent such depression predicts prognosis independently of disease severity. Method: An individual patient data meta-analysis of studies was conducted using multilevel, multivariable Cox regression analyses. Results: Sixteen studies participated, creating a database of 10 175 post-infarction cases. Hazard ratios for post-infarction depression were 1.32 (95% CI 1.26-1.38, P<0.001) for allcause mortality and 1.19 (95% CI 1.14-1.24, P<0.001) for cardiovascular events. Hazard ratios adjusted for disease severity were attenuated by 28% and 25% respectively. Conclusions: The association between depression following myocardial infarction 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.

Original languageEnglish (US)
Pages (from-to)90-102
Number of pages13
JournalBritish Journal of Psychiatry
Volume203
Issue number2
DOIs
StatePublished - Aug 2013

ASJC Scopus subject areas

  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: Individual patient data meta-analysis'. Together they form a unique fingerprint.

Cite this