Individual depressive symptoms and all cause mortality in 6673 patients with myocardial infarction

Heterogeneity across age and sex subgroups

Ricardo De Miranda Azevedo, A.M. Roest, Robert M. Carney, Kenneth E. Freedland, Deirdre A. Lane, Kapil Parakh, Peter De Jonge, J. Denollet

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: 

Depression predicts poor prognosis in patients with myocardial infarction (MI). However, individual depressive symptoms may have different prognostic value, and age and sex could be important effect modifiers. This study compared the prognostic value of individual depressive symptoms across age and sex subgroups in post-MI patients.

Methods: 

Individual patient-data were compiled for 6673 post-MI patients from seven studies. Depressive symptoms were measured with 10 items of the Beck Depression Inventory (BDI10). The endpoint was all-cause mortality (mean= 3.8 years). Multilevel multivariable Cox regression analysis was used to estimate the mortality risk across age groups (= 55, 56-69 and = 70 years) and sex for symptoms that potentially interacted with age and sex.

Results: 

At follow-up, 995 (15%) post-MI patients had died. BDI10 depression scores were associated with an increased mortality risk (HR: 1.20; 95% CI: 1.11-1.28, p 70. Fatigue was associated with mortality in women aged 56-69 (HR: 1.54; 1.09-2.15; p=. 012), and suicidal ideation in women aged > 70 (HR: 1.58; 1.03-2.43; p=. 037). Left-ventricular ejection fraction (LVEF) accounted for much of the associations in men = 70 years. Limitations: Findings are sample-specific and need replication in future research; BDI10 items were derived from the original BDI assessment.

Conclusions: 

There is large heterogeneity in the prognostic value of individual depressive symptoms in post-MI patients across sex and age subgroups. LVEF partially explained the depression-prognosis association in specific subgroups.

Original languageEnglish
Pages (from-to)178-185
JournalJournal of Affective Disorders
Volume228
DOIs
Publication statusPublished - 2018

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Keywords

  • ASSOCIATION
  • DATA METAANALYSIS
  • Depression
  • Epidemiology
  • HEART-DISEASE
  • INVENTORY
  • Myocardial infarction
  • PROGNOSIS
  • TERM

Cite this

De Miranda Azevedo, Ricardo ; Roest, A.M. ; Carney, Robert M. ; Freedland, Kenneth E. ; Lane, Deirdre A. ; Parakh, Kapil ; De Jonge, Peter ; Denollet, J. / Individual depressive symptoms and all cause mortality in 6673 patients with myocardial infarction : Heterogeneity across age and sex subgroups. In: Journal of Affective Disorders. 2018 ; Vol. 228. pp. 178-185.
@article{77344301051c46d4898b3ac33d48355d,
title = "Individual depressive symptoms and all cause mortality in 6673 patients with myocardial infarction: Heterogeneity across age and sex subgroups",
abstract = "Background: Depression predicts poor prognosis in patients with myocardial infarction (MI). However, individual depressive symptoms may have different prognostic value, and age and sex could be important effect modifiers. This study compared the prognostic value of individual depressive symptoms across age and sex subgroups in post-MI patients.Methods: Individual patient-data were compiled for 6673 post-MI patients from seven studies. Depressive symptoms were measured with 10 items of the Beck Depression Inventory (BDI10). The endpoint was all-cause mortality (mean= 3.8 years). Multilevel multivariable Cox regression analysis was used to estimate the mortality risk across age groups (= 55, 56-69 and = 70 years) and sex for symptoms that potentially interacted with age and sex.Results: At follow-up, 995 (15{\%}) post-MI patients had died. BDI10 depression scores were associated with an increased mortality risk (HR: 1.20; 95{\%} CI: 1.11-1.28, p 70. Fatigue was associated with mortality in women aged 56-69 (HR: 1.54; 1.09-2.15; p=. 012), and suicidal ideation in women aged > 70 (HR: 1.58; 1.03-2.43; p=. 037). Left-ventricular ejection fraction (LVEF) accounted for much of the associations in men = 70 years. Limitations: Findings are sample-specific and need replication in future research; BDI10 items were derived from the original BDI assessment.Conclusions: There is large heterogeneity in the prognostic value of individual depressive symptoms in post-MI patients across sex and age subgroups. LVEF partially explained the depression-prognosis association in specific subgroups.",
keywords = "ASSOCIATION, DATA METAANALYSIS, Depression, Epidemiology, HEART-DISEASE, INVENTORY, Myocardial infarction, PROGNOSIS, TERM",
author = "{De Miranda Azevedo}, Ricardo and A.M. Roest and Carney, {Robert M.} and Freedland, {Kenneth E.} and Lane, {Deirdre A.} and Kapil Parakh and {De Jonge}, Peter and J. Denollet",
year = "2018",
doi = "10.1016/j.jad.2017.11.025",
language = "English",
volume = "228",
pages = "178--185",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",

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Individual depressive symptoms and all cause mortality in 6673 patients with myocardial infarction : Heterogeneity across age and sex subgroups. / De Miranda Azevedo, Ricardo; Roest, A.M.; Carney, Robert M.; Freedland, Kenneth E.; Lane, Deirdre A.; Parakh, Kapil; De Jonge, Peter; Denollet, J.

In: Journal of Affective Disorders, Vol. 228, 2018, p. 178-185.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Individual depressive symptoms and all cause mortality in 6673 patients with myocardial infarction

T2 - Heterogeneity across age and sex subgroups

AU - De Miranda Azevedo, Ricardo

AU - Roest, A.M.

AU - Carney, Robert M.

AU - Freedland, Kenneth E.

AU - Lane, Deirdre A.

AU - Parakh, Kapil

AU - De Jonge, Peter

AU - Denollet, J.

PY - 2018

Y1 - 2018

N2 - Background: Depression predicts poor prognosis in patients with myocardial infarction (MI). However, individual depressive symptoms may have different prognostic value, and age and sex could be important effect modifiers. This study compared the prognostic value of individual depressive symptoms across age and sex subgroups in post-MI patients.Methods: Individual patient-data were compiled for 6673 post-MI patients from seven studies. Depressive symptoms were measured with 10 items of the Beck Depression Inventory (BDI10). The endpoint was all-cause mortality (mean= 3.8 years). Multilevel multivariable Cox regression analysis was used to estimate the mortality risk across age groups (= 55, 56-69 and = 70 years) and sex for symptoms that potentially interacted with age and sex.Results: At follow-up, 995 (15%) post-MI patients had died. BDI10 depression scores were associated with an increased mortality risk (HR: 1.20; 95% CI: 1.11-1.28, p 70. Fatigue was associated with mortality in women aged 56-69 (HR: 1.54; 1.09-2.15; p=. 012), and suicidal ideation in women aged > 70 (HR: 1.58; 1.03-2.43; p=. 037). Left-ventricular ejection fraction (LVEF) accounted for much of the associations in men = 70 years. Limitations: Findings are sample-specific and need replication in future research; BDI10 items were derived from the original BDI assessment.Conclusions: There is large heterogeneity in the prognostic value of individual depressive symptoms in post-MI patients across sex and age subgroups. LVEF partially explained the depression-prognosis association in specific subgroups.

AB - Background: Depression predicts poor prognosis in patients with myocardial infarction (MI). However, individual depressive symptoms may have different prognostic value, and age and sex could be important effect modifiers. This study compared the prognostic value of individual depressive symptoms across age and sex subgroups in post-MI patients.Methods: Individual patient-data were compiled for 6673 post-MI patients from seven studies. Depressive symptoms were measured with 10 items of the Beck Depression Inventory (BDI10). The endpoint was all-cause mortality (mean= 3.8 years). Multilevel multivariable Cox regression analysis was used to estimate the mortality risk across age groups (= 55, 56-69 and = 70 years) and sex for symptoms that potentially interacted with age and sex.Results: At follow-up, 995 (15%) post-MI patients had died. BDI10 depression scores were associated with an increased mortality risk (HR: 1.20; 95% CI: 1.11-1.28, p 70. Fatigue was associated with mortality in women aged 56-69 (HR: 1.54; 1.09-2.15; p=. 012), and suicidal ideation in women aged > 70 (HR: 1.58; 1.03-2.43; p=. 037). Left-ventricular ejection fraction (LVEF) accounted for much of the associations in men = 70 years. Limitations: Findings are sample-specific and need replication in future research; BDI10 items were derived from the original BDI assessment.Conclusions: There is large heterogeneity in the prognostic value of individual depressive symptoms in post-MI patients across sex and age subgroups. LVEF partially explained the depression-prognosis association in specific subgroups.

KW - ASSOCIATION

KW - DATA METAANALYSIS

KW - Depression

KW - Epidemiology

KW - HEART-DISEASE

KW - INVENTORY

KW - Myocardial infarction

KW - PROGNOSIS

KW - TERM

U2 - 10.1016/j.jad.2017.11.025

DO - 10.1016/j.jad.2017.11.025

M3 - Article

VL - 228

SP - 178

EP - 185

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -