Abstract 3585: The Contribution of Depression to Myocardial Infarction Outcomes among Caucasians and African Americans
Background: Depression predicts worse outcomes after myocardial infarction (MI), but whether the association between depression and post-MI outcomes differs according to race is unknown.
Methods: In a prospective study of MI (PREMIER), depressive symptoms were measured in 2226 patients using the Patient Health Questionnaire (PHQ) during hospitalization. Depression was defined as PHQ score ≥10 (moderate-severe depressive symptoms). Outcomes included 2-yr mortality, 1-yr rehospitalization, and 1-yr health status (angina and quality of life using the Seattle Angina Questionnaire [SAQ], and physical limitation using the Short-Form-12). Multivariable models were used to evaluate the association between depression and the outcomes, stratified by Caucasian and African-American (AA) race.
Results: Depression was more prevalent in AA’s as compared with Caucasians (30% vs 20%, P<.001). However, after adjusting for clinical characteristics, depressed Caucasians were 53% more likely to have angina at 1-yr compared with non-depressed Caucasians, but no significant association was found among AAs (interaction p<0.001). In contrast, the effect of depression on rehospitalization, quality of Life, and physical function did not significantly vary by race (interaction terms not significant) (Figure⇓).
Conclusions: Depression predicts 1-year post-MI angina in Caucasians, but not AAs, despite a higher prevalence of depression among AA’s. Depression does not differentially contribute to other outcomes based on race. These results support depression recognition and treatment irrespective of race, but also suggest the need to better understand the drivers of angina in AAs.