The impact of post acute myocardial infarction (AMI) depression on patient compliance and risk factor modification

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Abstract
Numerous studies have examined depression as both a predictor and an indicator of recovery from acute myocardial infarction (AMI). The precise mechanism which links depression and morbidity/mortality remains unclear, but it has been suggested that compliance with physician instructions and related risk factor modification may play a key role. The intent of this prospective study was to assess the relationship between post-AMI depression and patient observation of physician discharge instructions and healthy lifestyle choices. Data was collected for 245 AMI hospital inpatients and three-months following discharge. There were no significant differences in the initiation and/or completion of cardiac rehabilitation programmes, diet modifications or exercise maintenance according to depressed status; however, the current use of tobacco was strongly related to level of depression. Secondary analyses revealed differences regarding quality of life (presence of angina, dyspnea and fatigue), morbidity (number of physician visits and rehospitalization rates), socioeconomic factors (employment status and income level) and demographic factors (race and gender).