Editorial
The importance of depression following myocardial infarction
| The first 150 words of the full text of this article appear below. |
Depressive disorder, as defined by standardised research criteria, is recorded in 13-19% of patients at the time of myocardial infarction (MI).1-7 The disorder is important in MI patients because depression is associated with several adverse outcomes: increased mortality,1 5-7 angina,2 arrhythmias,2 6 8 rehospitalisation, prolonged disability, and continued smoking.
Increased mortalityThere is increasing evidence that depressed myocardial infarction
patients have an increased mortality rate1-6; this effect appears to be independent of the severity of MI and is impressive. In
the most quoted study, examining six month mortality, patients with
major depression had an increased mortality rate: after adjusting for
other factors (previous MI, age and Killip class) the adjusted hazard
ratio was 3.3 (95% confidence intervals (CI) 1.96 to
4.68).1 At 18 months' follow up the adjusted odds ratio
was 6.6 for patients who had depressive symptoms shortly after the
MI.5 If these results were replicated in the UK, the
increased mortality associated with depressive
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