African-Americans with depression and heart attack have greater risk of death

Nov 12 2008

African-American patients with acute myocardial infarction (MI) and previously treated depression that persists at their MI hospitalization have an increased risk of post-MI death, according to Emory researcher Susmita Parashar, MD, MPH.

Parashar, a member of the cardiology division, Emory University School of Medicine, presented findings Nov. 12 at the American Heart Association Scientific Sessions conference in New Orleans.

"Our study shows that prior depression that persists at the time of MI may indicate a more severe, enduring or recurrent depression," says Parashar. "Thus, it is important to screen and identify persistent depressive symptoms at the time of hospitalization for MI because targeting of interventions regarding persistent depression may improve outcomes."

Often referred to as a heart attack, MI occurs when the blood supply to part of the heart is interrupted. This decreased blood supply is commonly due to blockage of a coronary artery and if left untreated can cause damage and/or death (infarction) of heart muscle tissue.

Classical symptoms of acute MI include sudden chest pain, shortness of breath, nausea, vomiting, palpatations, sweating and anxiety. Heart attacks are the leading cause of death for both men and women in the U.S. Risk factors include cardiovascular disease, older age, tobacco use, diabetes, high blood pressure, obesity, chronic kidney disease, heart failure, excessive alcohol consumption and chronic high level of stress.

Using the Patient Health Questionnaire as part of a prospective myocardial infraction registry, Parashar and her team measured depressive symptoms in 397 African-American MI patients at Grady Memorial Hospital in metro Atlanta.

Patients were assessed and categorized as past, new, persistent or never depressed. Patients were followed up for a maximum of 58 months after MI. Researchers examined the relative prognostic importance of current, past versus persistent depression on mortality among African Americans with acute MI adjusting for demographic, clinical and quality of care variables.

Preliminary results show patients with persistent depression were almost three times as likely to die after MI compared with never depressed patients.