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Pre-Existing Major Depression Predicts In-Hospital Cardiac Complications After Acute Myocardial Infarction

Received January 19, 2007; accepted March 16, 2007. From the Dept. of Psychiatry and the Dept. of Cardiology, Massachusetts General Hospital; Boston, MA; and the Harvard Medical School, Boston, MA. Send correspondence and reprint requests to Jeff C. Huffman, M.D., Massachusetts General Hospital, 55 Fruit Street/Warren 1220C, Boston, MA 02114. e-mail: jhuffman{at}partners.org

BACKGROUND: Depression (MDD) and anxiety have been associated with negative long-term outcomes among patients with acute myocardial infarction (MI). OBJECTIVE: The objective of the study was to determine whether MDD and anxiety preceding MI were associated with in-hospital post-MI cardiac complications. METHOD: Subjects (N=129) underwent psychiatric interviews within 72 hours of MI and were evaluated for five in-hospital cardiac complications (recurrent ischemia, ventricular arrhythmia, ventricular arrhythmia requiring intervention, congestive heart failure, and reinfarction). RESULTS: Current (pre-MI) MDD was a significant and independent predictor of all complications except recurrent ischemia on multivariate regression analysis. In contrast, pre-MI anxiety was not associated with complications. CONCLUSION: These findings underscore the importance of identifying and treating MDD in post-MI patients and those at risk for MI.

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