Prediction of depressive disorder following myocardial infarction Data from the Myocardial INfarction and Depression-Intervention Trial (MIND-IT)

JP van Melle*, P de Jonge, AMG Kuyper, A Honig, AH Schene, HJGM Crijns, MP van den Berg, DJ van Veldhuisen, J Ormel, MIND-IT Investigators

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

40 Citations (Scopus)

Abstract

Background: Depression following myocardial infarction (MI) is associated with complicated cardiac rehabilitation, non-compliance and poor prognosis. Whether depression following MI can be predicted from variables routinely assessed during hospitalization for MI is unknown.

Methods: Using data from the Myocardial INfarction and Depression- Intervention Trial (MIND-IT), we identified 2177 MI patients (mean age 63 years-, 23% female). Patients were randomly divided into a derivation and a validation sample. In the derivation sample, we analyzed variables potentially associated with the development of post-MI depressive disorder, which were tested in the validation sample.

Results: In the year following Ml, 18.5% suffered from depressive disorder(ICD-10 criteria). In a multivariate model, factors associated with depression were younger age (OR 1.94; Cl 1.38-2.74), hypercholesterolemia (OR 1.68; Cl 1.08-2.61), the use of calcium channel blockers at discharge (OR 1.80; Cl 1.20-2.71), and left ventricular ejection fraction (LVEF) (OR 4.14 for patients with LVEF <30%; Cl (2.42-7.10). The derived predictors were tested in the validation sample. The final model yielded two clinical predictors, i.e., younger age and severe LV-dysfunction, which correctly predicted post-discharge depression status in 82.9% of the MI patients. The model yielded a high negative predictive value (89%). A positive depression questionnaire (BDI) during hospitalization increased the positive predictive value of 23% to 52%.

Conclusions: During hospitalization for MI and using a two-step strategy with common clinical variables, i.e., younger age, severe LV-dysfunction and BDI score during hospitalization, it is possible to identify MI patients with a high risk for subsequent development of depression. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)88-94
Number of pages7
JournalInternational Journal of Cardiology
Volume109
Issue number1
DOIs
Publication statusPublished - 28-Apr-2006

Keywords

  • myocardial infarction
  • cardiac rehabilitation
  • depression
  • risk factors
  • CORONARY-ARTERY DISEASE
  • QUALITY-OF-LIFE
  • MAJOR DEPRESSION
  • CARDIAC-REHABILITATION
  • SOCIAL SUPPORT
  • HEART-FAILURE
  • SYMPTOMS
  • PROGNOSIS
  • ANXIETY
  • EVENTS

Cite this