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Depression linked to post-MI patients

Article

"We know that there's a strong relationship between depression and heart disease, and we need to know a lot more about it," said Lee Green, MD, MPH, of the University of Michigan and Director of the Great Lakes Research and Practice Network.

"We know that there's a strong relationship between depression and heart disease, and we need to know a lot more about it," said Lee Green, MD, MPH, of the University of Michigan and Director of the Great Lakes Research and Practice Network.

Dr Green presented the evidence report for the next guideline for post-MI depression, which will be released within the next few months.

Research helped in part by Johns Hopkins University showed that 20% of post-MI patients suffered from depression. Ten percent to 47% of post-MI patients demonstrated potentially significant symptoms of depression, but were not necessarily diagnosed. Another link was found between persistent depression more than a month after acute MI.

However, Dr Green admitted the flaws in the data. "We don't know how many patients were depressed to begin with."

Patients struggling with post-MI depression had a significantly higher risk of death associated with cardiac disease, as well as increased risks of hospital readmission within the first year after surgery and non-fatal cardiac events. These patients, male and female, also experienced a lower quality of life, a delayed return to work, and decreased sexual satisfaction and social role function.

Psychosocial interventions can help alleviate depression and improve social role function, but they have not been proven to better cardiac outcomes.

"There is consistent evidence of reduced compliance with both cardiac medications and lifestyle changes among depressed patients," Dr Green said, "but more research is needed to find out whether treating depression treatment improves medication compliance." So far, little research exists that examines the relationship between cardiac conditions and depression, he explained.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health