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 articleScientificpeer-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 all-cause 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
Pages (from-to)90-102
JournalBritish Journal of Psychiatry
Volume203
Issue number2
DOIs
Publication statusPublished - 2013

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Meijer, A. ; Conradi, H.J. ; Bos, E.H. ; Anselmino, M. ; Carney, R.M. ; Denollet, J. ; Doyle, F. ; Freedland, K.E. ; Grace, S.L. ; Hosseini, S.H. ; Lane, D.A. ; Pilote, L. ; Parakh, K. ; Rafanelli, C. ; Sato, H. ; Steeds, R.P. ; Welin, C. ; de Jonge, P. / Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events : Individual patient data meta-analysis. In: British Journal of Psychiatry. 2013 ; Vol. 203, No. 2. pp. 90-102.
@article{59f941355b2c49aab15cfda04bdd9472,
title = "Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: Individual patient data meta-analysis",
abstract = "BackgroundThe association between depression after myocardial infarction and increased risk of mortality and cardiac morbidity may be due to cardiac disease severity.AimsTo 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.MethodAn individual patient data meta-analysis of studies was conducted using multilevel, multivariable Cox regression analyses.ResultsSixteen 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 all-cause 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.ConclusionsThe 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.",
author = "A. Meijer and H.J. Conradi and E.H. Bos and M. Anselmino and R.M. Carney and J. Denollet and F. Doyle and K.E. Freedland and S.L. Grace and S.H. Hosseini and D.A. Lane and L. Pilote and K. Parakh and C. Rafanelli and H. Sato and R.P. Steeds and C. Welin and {de Jonge}, P.",
year = "2013",
doi = "10.1192/bjp.bp.112.111195",
language = "English",
volume = "203",
pages = "90--102",
journal = "British Journal of Psychiatry",
issn = "0007-1250",
publisher = "Royal College of Psychiatrists",
number = "2",

}

Meijer, A, Conradi, HJ, Bos, EH, Anselmino, M, Carney, RM, Denollet, J, Doyle, F, Freedland, KE, Grace, SL, Hosseini, SH, Lane, DA, Pilote, L, Parakh, K, Rafanelli, C, Sato, H, Steeds, RP, Welin, C & de Jonge, P 2013, 'Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: Individual patient data meta-analysis' British Journal of Psychiatry, vol. 203, no. 2, pp. 90-102. https://doi.org/10.1192/bjp.bp.112.111195

Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events : Individual patient data meta-analysis. / Meijer, A.; Conradi, H.J.; Bos, E.H.; Anselmino, M.; Carney, R.M.; Denollet, J.; Doyle, F.; Freedland, K.E.; Grace, S.L.; Hosseini, S.H.; Lane, D.A.; Pilote, L.; Parakh, K.; Rafanelli, C.; Sato, H.; Steeds, R.P.; Welin, C.; de Jonge, P.

In: British Journal of Psychiatry, Vol. 203, No. 2, 2013, p. 90-102.

Research output: Contribution to journalReview articleScientificpeer-review

TY - JOUR

T1 - Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events

T2 - Individual patient data meta-analysis

AU - Meijer, A.

AU - Conradi, H.J.

AU - Bos, E.H.

AU - Anselmino, M.

AU - Carney, R.M.

AU - Denollet, J.

AU - Doyle, F.

AU - Freedland, K.E.

AU - Grace, S.L.

AU - Hosseini, S.H.

AU - Lane, D.A.

AU - Pilote, L.

AU - Parakh, K.

AU - Rafanelli, C.

AU - Sato, H.

AU - Steeds, R.P.

AU - Welin, C.

AU - de Jonge, P.

PY - 2013

Y1 - 2013

N2 - BackgroundThe association between depression after myocardial infarction and increased risk of mortality and cardiac morbidity may be due to cardiac disease severity.AimsTo 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.MethodAn individual patient data meta-analysis of studies was conducted using multilevel, multivariable Cox regression analyses.ResultsSixteen 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 all-cause 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.ConclusionsThe 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.

AB - BackgroundThe association between depression after myocardial infarction and increased risk of mortality and cardiac morbidity may be due to cardiac disease severity.AimsTo 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.MethodAn individual patient data meta-analysis of studies was conducted using multilevel, multivariable Cox regression analyses.ResultsSixteen 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 all-cause 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.ConclusionsThe 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.

U2 - 10.1192/bjp.bp.112.111195

DO - 10.1192/bjp.bp.112.111195

M3 - Review article

VL - 203

SP - 90

EP - 102

JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

SN - 0007-1250

IS - 2

ER -