Abstract 9950: Patients With Depressive Symptoms Experienced Substantial Adverse Cardiac Remodeling After Myocardial Infarction
Background: Mechanisms underlying post-MI depression and cardiac events in CAD patients remain poorly understood. The OMEGA-REMODEL Study is a randomized double-blind trial assessing for any benefical effects of post-MI LV remodeling by high-dose Omega-3 fatty acids (n-3 FAs). As a post-hoc analysis, we tested the hypothesis that patients with higher depression scores experienced more severe adverse post-MI remodeling.
Methods: 358 patients with acute MI were randomized to placebo or 4g/d n-3 FAs with 2-4 weeks post-MI. All patients underwent Hamilton Depression Scale, cardiac MRI, inflammatory biomarkers, and red cell n-3 index at baseline and after 6 months of study drug. Patients were stratified by median depression score as DEP and non-DEP.
Results: Demographics and baseline LV measurements are shown in Table 1. N-3 FAs assignment resulted in significant improvement in LVESV compared to placebo. Compared to patients without DEP at baseline, those with DEP had slightly smaller LVEDV but similar LVESV, LVEF and infarct size. However, patients with DEP experienced marked expansion of LVEDV and LVESV compared to patients without DEP during the 6 months study period (P=0.007 and 0.02, respectively). N-3 FAs appeared to benefit LV remodeling of patients with or without DEP. Inflammatory markers did not correlate with the severity of the adverse LV remodeling.
Conclusion: In conclusion, patients with DEP were substantially more likely to experience adverse cardiac remodeling which may account for the adverse cardiac outcomes of post MI depression.
Table 1: Baseline Features and Changes in Cardiac Parameters
Author Disclosures: G. Ipek: None. B. Heydari: None. S. Abdullah: None. D. Mandry: None. J.H. Feng: None. E. Antman: None. M. Jerosh-Herold: None. R.Y. Kwong: None.
- © 2015 by American Heart Association, Inc.