Background
Depression is considered a risk factor for coronary heart disease (CHD) in initially
CHD-free populations. Subclinical CHD or other somatic causes of depressive symptoms
might account for the association, however.
Methods
In this case–control study, patients had had their first acute myocardial infarction
(AMI). The study included 1799 cases, aged 45–70 years, and 2339, age-, gender-, and
hospital-catchment-area-matched control subjects. We calculated odds ratios (OR) with
95% confidence intervals (CI) by multivariate logistic regressions to assess the AMI
risk associated with a hospitalization for depression.
Results
Forty-seven cases and 22 control subjects had been hospitalized for depression. After
adjustment for matching criteria and socioeconomic status, the OR for AMI was 2.9
(1.8–4.9) for ever hospitalized for depression. Patients hospitalized for depression
before or after the median time, 15 years and 2 months, between the first hospitalization
for depression and AMI, were at similar risk. Adjustment for lifestyle, lipid profile,
coagulation, inflammation, prior cardiovascular events, and comorbidity only partly
decreased the observed association.
Conclusions
Depression was associated with increased risk for AMI. Subclinical CHD or other somatic
causes are unlikely to account for our findings, which also appear not to be explained
by established risk factors for AMI.
Key Words
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References
- Depressed affect, hopelessness, and the risk of ischemic heart disease in a cohort of U.S. adults.Epidemiology. 1993; 4: 285-294
- Mortality of patients with mood disorders: Follow-up over 34–38 years.J Affect Disord. 2002; 68: 167-181
- Depressive symptoms and risks of coronary heart disease and mortality in elderly Americans.Circulation. 2000; 102: 1773-1779
- Depression and cardiovascular diseases.Acta Psychiatr Scand Suppl. 1994; 377: 77-82
- Symptoms of depression, acute myocardial infarction, and total mortality in a community sample.Circulation. 1996; 93: 1976-1980
- Task Force # 1.J Am Coll Cardiol. 2002; 40: 588-603
- Effects of treating depression and low perceived social support on clinical events after myocardial infarction: The enhancing recovery in coronary heart disease patients (ENRICHD) randomized trial.JAMA. 2003; 289: 3106-3116
- Combined action of the ACE D- and the G-protein beta3 T-allele in major depression: A possible link to cardiovascular disease?.Mol Psychiatry. 2002; 7: 1120-1126
- Depression, mortality, and medical morbidity in patients with coronary heart disease.Biol Psychiatry. 2003; 54: 241-247
- Medical comorbidity and late life depression: What is known and what are the unmet needs?.Biol Psychiatry. 2002; 52: 226-235
- History of treatment for depression: Risk factor for myocardial infarction in hypertensive patients.Psychosom Med. 2001; 63: 203-209
- Personality, disease severity, and the risk of long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction.Circulation. 1998; 97: 167-173
- Depression as an antecedent to heart disease among women and men in the NHANES I study.Arch Intern Med. 2000; 160: 1261-1268
- Depression is a risk factor for coronary artery disease in men: The precursors study.Arch Intern Med. 1998; 158: 1422-1426
- Reflections on depression as a cardiac risk factor.Psychosom Med. 2005; 67: S19-S25
- IL-6 levels in acute and post myocardial infarction: Their relation to CRP levels, infarction size, left ventricular systolic function, and heart failure.Eur J Intern Med. 2004; 15: 523-528
- Sertraline treatment of major depression in patients with acute MI or unstable angina.JAMA. 2002; 288: 701-709
- Psychosocial factors and risk of ischaemic heart disease and death in women: A twelve-year follow-up of participants in the population study of women in Gothenburg, Sweden.J Psychosom Res. 1986; 30: 451-459
- Depression as a risk factor for ischaemic heart disease in men: Population based case-control study.BMJ. 1998; 316: 1714-1719
- Lifetime history of depression and carotid atherosclerosis in middle-aged women.Arch Gen Psychiatry. 2003; 60: 153-160
- Depression and cardiovascular disease: Mechanisms of interaction.Biol Psychiatry. 2003; 54: 248-261
- Diabetes, psychotic disorders and antipsychotic therapy: A consensus statement.Med J Aust. 2004; 181: 544-548
- Depression and risk of coronary heart disease in elderly men and women.Arch Intern Med. 1998; 158: 2341-2348
- Lack of correlation between psychological factors and subclinical coronary artery disease.N Engl J Med. 2000; 343: 1298-1304
- Speculations on difference between tricyclic and selective serotonin reuptake inhibitor antidepressants on their cardiac effects.Curr Med Chem. 1999; 6: 469-480
- Depression and cardiac mortality: Results from a community-based longitudinal study.Arch Gen Psychiatry. 2001; 58: 221-227
- Cardiovascular events and mortality in newly and chronically depressed persons > 70 years of age.Am J Cardiol. 1998; 81: 988-994
- Depression, psychotropic medication, and risk of myocardial infarction.Circulation. 1996; 94: 3123-3129
- High fatality rates of late-life depression associated with cardiovascular disease.J Affect Disord. 1985; 9: 165-167
- Resolved: Psychosocial interventions can improve clinical outcomes in organic disease (con).Psychosom Med. 2002; 64: 558-563
- Higher relative, but lower absolute risks of myocardial infarction in women than in men: Analysis of some major risk factors in the SHEEP study.J Intern Med. 1999; 246: 161-174
- Epidemiology of comorbid coronary artery disease and depression.Biol Psychiatry. 2003; 54: 227-240
- Are sleep complaints an independent risk factor for myocardial infarction?.Ann Epidemiol. 1998; 8: 384-392
- Depression and the risk of coronary heart disease in the Normative Aging Study.Am J Cardiol. 1998; 82: 851-856
- Mortality in affective disorder.J Affect Disord. 1994; 31: 91-96
- Severe depression is associated with markedly reduced heart rate variability in patients with stable coronary heart disease.J Psychosom Res. 2000; 48: 493-500
- Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Investigators.Eur Heart J. 2003; 24: 2027-2037
- Psychosocial factors in the development of coronary artery disease.Prog Cardiovasc Dis. 2004; 46: 337-347
- Psychosocial risk factors for heart disease in France and Northern Ireland: The Prospective Epidemiological Study of Myocardial Infarction (PRIME).Int J Epidemiol. 2002; 31: 1227-1234
- Depressive symptoms and mortality in elderly persons.J Gerontol. 1992; 47: S80-S87
- Effect of negative emotions on frequency of coronary heart disease (The Normative Aging Study).Am J Cardiol. 2003; 92: 901-906
- Impact of reduced heart rate variability on risk for cardiac events.Circulation. 1995; 94: 2850-2855
- Mental health status as a predictor of morbidity and mortality: A 15-year follow-up of members of a health maintenance organization.Am J Public Health. 1994; 84: 227-231
- Change in depression as a precursor of cardiovascular events.Arch Intern Med. 1996; 156: 553-561
- Depression and cardiovascular sequelae in postmenopausal women.Arch Intern Med. 2004; 164: 289-298
- Cardiovascular death and manic-depressive psychosis.J Affect Disord. 1987; 13: 287-292
- Association between depressive symptoms and mortality in older women.Arch Intern Med. 1998; 158: 2129-2135
- Do depressive symptoms increase the risk for the onset of coronary disease?.Psychosom Med. 2003; 65: 201-210
Article info
Publication history
Published online: December 11, 2006
Accepted:
August 4,
2006
Received in revised form:
June 28,
2006
Received:
April 28,
2006
Identification
Copyright
© 2007 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
