Gender, depression, and one-year prognosis after myocardial infarction

Objective: The purpose of this study was to assess gender differences in th e impact of depression on 1-year cardiac mortality in patients hospitalized for an acute myocardial infarction (MI), Methods: Secondary analysis was p erformed on data from two studies that used the Beck Depression Inventory ( BDI) to assess depression symptoms during hospitalization: a prospective st udy of post-MI risk and a randomized trial of psychosocial intervention (co ntrol group only). The sample included 896 patients (283 women) who survive d to discharge and received usual posthospital care. Multivariate logistic regression analysis was used to assess the risk of 1-year cardiac mortality associated with baseline BDI scores. Results: There were 290 patients (133 women) with BDI scores greater than or equal to 10 (at least mild to moder ate symptoms of depression): 8.3% of the depressed women died of cardiac ca uses in contrast to 2.7% of the nondepressed. For depressed men, the rate o f cardiac death was 7.0% in contrast to 2.4% of the nondepressed. Increased BDI scores were significantly related to cardiac mortality for both gender s [the odds ratio for women was 3.29 (95% confidence interval (CI) = 1.02-1 0.59); for men, the odds ratio was 3.05 (95% CI = 1.29-7.17)]. Control for other multivariate predictors of mortality in the data set (age, Killip cla ss, the interactions of gender by non-Q wave MI, gender by left ventricular ejection fraction, and gender by smoking) did not change the impact of the BDI for either gender. Conclusions: Depression in hospital after MI is a s ignificant predictor of 1-year cardiac mortality for women as well as for m en, and its impact is largely independent of other post-MI risks.