Abstract 5639: Persistent Depression Predicts Mortality among African Americans with Myocardial Infarction
Depression predicts adverse outcomes after myocardial infarction (MI), but the relative prognostic importance of new, past or current versus persistent depression among African Americans with MI is unknown. In a prospective MI registry in an inner-city hospital, we measured depressive symptoms in 397 African Americans hospitalized with MI using the Patient Health Questionnaire (PHQ). Patients were categorized as past (received depression treatment prior to MI), new (PHQ>=10 at hospitalization and no past depression), persistent (new plus past depression) or never-depressed. We examined the association between depression categories and 3-yr mortality using multivariable models after adjusting for demographic, clinical, and quality of care variables. There were no differences in sociodemographics, comorbidities and clinical factors among the past (7%), new (23%), persistent (6%) or never-depressed (64%) groups except a younger age in persistent depression group. Patients with persistent depression but not new or past depression had a higher mortality compared with the never-depressed (52% vs. 31%; P=0.02; 36% vs. 31%, P=0.90 and 28% vs. 31%, P=0.7 respectively). Patients with persistent depression were almost three times as likely to die at 3 yrs post-MI (adjusted HR 2.9; 95% CI 1.5, 5.5) as those who were never-depressed (Figure⇓). Previously treated depression that persists at MI hospitalization, but not new or past depression, strongly predicts post-MI mortality in African Americans. These findings suggest the need to screen MI patients for persistent depression.
This research has received full or partial funding support from the American Heart Association, AHA Greater Southeast Affiliate (Alabama, Florida, Georgia, Louisiana, Mississippi, Puerto Rico & Tennessee).