Depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.

<h4>Background</h4>Depressive symptoms is associated with adverse cardiovascular outcomes in patients with myocardial infarction (MI), but the underlying mechanisms are unclear and it remains unknown whether subgroups of patients are at a particularly high relative risk of adverse outcom...

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Autores principales:	Karen Kjær Larsen, Bo Christensen, Jens Søndergaard, Mogens Vestergaard
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9836ea4b8c344129b12915a30594a057
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spelling	oai:doaj.org-article:9836ea4b8c344129b12915a30594a0572021-11-18T08:53:43ZDepressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.1932-620310.1371/journal.pone.0074393https://doaj.org/article/9836ea4b8c344129b12915a30594a0572013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24086339/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Depressive symptoms is associated with adverse cardiovascular outcomes in patients with myocardial infarction (MI), but the underlying mechanisms are unclear and it remains unknown whether subgroups of patients are at a particularly high relative risk of adverse outcomes. We examined the risk of new cardiovascular events and/or death in patients with depressive symptoms following first-time MI taking into account other secondary preventive factors. We further explored whether we could identify subgroups of patients with a particularly high relative risk of adverse outcomes.<h4>Methods and results</h4>We conducted a prospective population-based cohort study of 897 patients discharged with first-time MI between 1 January 2009 and 31 December 2009, and followed up until 31 July 2012. Depressive symptoms were found in 18.6% using the Hospital Anxiety and Depression Scale (HADS-D≥8). A total of 239 new cardiovascular events, 95 deaths, and 288 composite events (239 new cardiovascular events and 49 deaths) occurred during 1,975 person-years of follow-up. Event-free survival was evaluated using Cox regression analysis. Compared to the 730 patients without depressive symptoms (HADS-D<8), the 167 patients with depressive symptoms (HADS-D≥8) had age- and sex-adjusted hazard ratios [HR] (95% confidence interval [CI]) of 1.53 (95% CI, 1.14-2.05) for a new cardiovascular event, 3.10 (95% CI, 2.04-4.71) for death and 1.77 (95% CI, 1.36-2.31) for a composite event. The associations were attenuated when adjusted for disease severity, comorbid conditions and physical inactivity; HR = 1.17 (95% CI, 0.85-1.61) for a new cardiovascular event, HR = 2.01 (95% CI, 1.28-3.16) for death, and HR = 1.33 (95% CI, 1.00-1.76) for a composite event. No subgroups of patients had a particularly high risk of adverse outcomes.<h4>Conclusions</h4>Depressive symptoms following first-time MI was an independent prognostic risk factor for death, but not for new cardiovascular events. We found no subgroups of patients with a particularly high relative risk of adverse outcomes.Karen Kjær LarsenBo ChristensenJens SøndergaardMogens VestergaardPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 9, p e74393 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Karen Kjær Larsen Bo Christensen Jens Søndergaard Mogens Vestergaard Depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.
description	<h4>Background</h4>Depressive symptoms is associated with adverse cardiovascular outcomes in patients with myocardial infarction (MI), but the underlying mechanisms are unclear and it remains unknown whether subgroups of patients are at a particularly high relative risk of adverse outcomes. We examined the risk of new cardiovascular events and/or death in patients with depressive symptoms following first-time MI taking into account other secondary preventive factors. We further explored whether we could identify subgroups of patients with a particularly high relative risk of adverse outcomes.<h4>Methods and results</h4>We conducted a prospective population-based cohort study of 897 patients discharged with first-time MI between 1 January 2009 and 31 December 2009, and followed up until 31 July 2012. Depressive symptoms were found in 18.6% using the Hospital Anxiety and Depression Scale (HADS-D≥8). A total of 239 new cardiovascular events, 95 deaths, and 288 composite events (239 new cardiovascular events and 49 deaths) occurred during 1,975 person-years of follow-up. Event-free survival was evaluated using Cox regression analysis. Compared to the 730 patients without depressive symptoms (HADS-D<8), the 167 patients with depressive symptoms (HADS-D≥8) had age- and sex-adjusted hazard ratios [HR] (95% confidence interval [CI]) of 1.53 (95% CI, 1.14-2.05) for a new cardiovascular event, 3.10 (95% CI, 2.04-4.71) for death and 1.77 (95% CI, 1.36-2.31) for a composite event. The associations were attenuated when adjusted for disease severity, comorbid conditions and physical inactivity; HR = 1.17 (95% CI, 0.85-1.61) for a new cardiovascular event, HR = 2.01 (95% CI, 1.28-3.16) for death, and HR = 1.33 (95% CI, 1.00-1.76) for a composite event. No subgroups of patients had a particularly high risk of adverse outcomes.<h4>Conclusions</h4>Depressive symptoms following first-time MI was an independent prognostic risk factor for death, but not for new cardiovascular events. We found no subgroups of patients with a particularly high relative risk of adverse outcomes.
format	article
author	Karen Kjær Larsen Bo Christensen Jens Søndergaard Mogens Vestergaard
author_facet	Karen Kjær Larsen Bo Christensen Jens Søndergaard Mogens Vestergaard
author_sort	Karen Kjær Larsen
title	Depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.
title_short	Depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.
title_full	Depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.
title_fullStr	Depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.
title_full_unstemmed	Depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.
title_sort	depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/9836ea4b8c344129b12915a30594a057
work_keys_str_mv	AT karenkjærlarsen depressivesymptomsandriskofnewcardiovasculareventsordeathinpatientswithmyocardialinfarctionapopulationbasedlongitudinalstudyexamininghealthbehaviorsandhealthcareinterventions AT bochristensen depressivesymptomsandriskofnewcardiovasculareventsordeathinpatientswithmyocardialinfarctionapopulationbasedlongitudinalstudyexamininghealthbehaviorsandhealthcareinterventions AT jenssøndergaard depressivesymptomsandriskofnewcardiovasculareventsordeathinpatientswithmyocardialinfarctionapopulationbasedlongitudinalstudyexamininghealthbehaviorsandhealthcareinterventions AT mogensvestergaard depressivesymptomsandriskofnewcardiovasculareventsordeathinpatientswithmyocardialinfarctionapopulationbasedlongitudinalstudyexamininghealthbehaviorsandhealthcareinterventions
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Depressive symptoms and risk of new cardiovascular events or death in patients with myocardial infarction: a population-based longitudinal study examining health behaviors and health care interventions.

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