Longitudinal risk of cardiovascular events in relation to depression symptoms after discharge among survivors of myocardial infarction: Osaka acute coronary insufficiency study (OACIS)

Background: The purpose of this study was to investigate the association between depression symptoms 1 year after onset and subsequent cardiovascular events among survivors of myocardial infarction (MI). Methods and Results: The participants were recruited from respondents to a district-based survey known as the Osaka Acute Coronary Insufficiency Study. Of 4,271 eligible MI patients, 1,951 completed the Zung Self-Rating Depression Scale (SDS) at their 1-year follow-up examination. After excluding patients who experienced cardiovascular events within 1 year, the data for the remaining 1,307 male patients and 280 female patients were analyzed. Among male patients, depression status at 1 year after onset of MI was significantly related to risk of subsequent cardiovascular events throughout the follow-up period (median 2.9 years). The male patients in the top vs. bottom tertiles of SDS scores (top tertile being ≥42) had a multivariable-adjusted hazard ratio (HR) of 1.67 (95% confidence interval (CI) 1.01-2.77, P=0.04), and a 1-SD increment in SDS score was significantly related to a heightened risk of cardiovascular events, with a multivariable-adjusted HR of 1.30 (95%CI 1.07-1.58, P=0.01). There were no significant associations between SDS scores and cardiovascular events among female patients. Conclusions: Depression symptoms 1 year after onset of MI are a significant predictor of subsequent cardiovascular events for male patients.