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

doi:10.1192/bjp.bp.112.111195

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 journal › Article › peer-review

119 Citations (Scopus)

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 language	English
Pages (from-to)	90-102
Number of pages	13
Journal	British Journal of Psychiatry
Volume	203
Issue number	2
DOIs	https://doi.org/10.1192/bjp.bp.112.111195
Publication status	Published - Aug 2013

Keywords

Aged
Cardiovascular Diseases
Cause of Death
Comorbidity
Depressive Disorder
Female
Humans
Male
Middle Aged
Myocardial Infarction
Prognosis
Risk
Severity of Illness Index
Surveys and Questionnaires

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1192/bjp.bp.112.111195

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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. (2013). Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: individual patient data meta-analysis. British Journal of Psychiatry , 203(2), 90-102. https://doi.org/10.1192/bjp.bp.112.111195

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title = "Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: individual patient data meta-analysis",

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.",

keywords = "Aged, Cardiovascular Diseases, Cause of Death, Comorbidity, Depressive Disorder, Female, Humans, Male, Middle Aged, Myocardial Infarction, Prognosis, Risk, Severity of Illness Index, Surveys and Questionnaires",

author = "A Meijer and Conradi, {H J} and Bos, {E H} and M Anselmino and Carney, {R M} and J Denollet and F Doyle and Freedland, {K E} and Grace, {S L} and Hosseini, {S H} and Lane, {D A} and L Pilote and K Parakh and C Rafanelli and H Sato and Steeds, {R P} and C Welin and {de Jonge}, P",

year = "2013",

month = aug,

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",

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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

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 - 2013/8

Y1 - 2013/8

N2 - 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.

AB - 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.

KW - Aged

KW - Cardiovascular Diseases

KW - Cause of Death

KW - Comorbidity

KW - Depressive Disorder

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Prognosis

KW - Risk

KW - Severity of Illness Index

KW - Surveys and Questionnaires

U2 - 10.1192/bjp.bp.112.111195

DO - 10.1192/bjp.bp.112.111195

M3 - Article

C2 - 23908341

SN - 0007-1250

VL - 203

SP - 90

EP - 102

JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

IS - 2

ER -

Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: individual patient data meta-analysis

Abstract

Keywords

UN SDGs

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