The importance of depression following myocardial infarction

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Abstract
There is increasing evidence that depressed myocardial infarction patients have an increased mortality rate1-6; this effect appears to be independent of the severity of MI and is impressive. In the most quoted study, examining six month mortality, patients with major depression had an increased mortality rate: after adjusting for other factors (previous MI, age and Killip class) the adjusted hazard ratio was 3.3 (95% confidence intervals (CI) 1.96 to 4.68).1 At 18 months’ follow up the adjusted odds ratio was 6.6 for patients who had depressive symptoms shortly after the MI.5 If these results were replicated in the UK, the increased mortality associated with depressive disorder would represent approximately 20 000 patients per annum.