Adjusted prognostic association of post-myocardial infarction depression withmortality and cardiovascular events: an individual patient data meta-analysis

Background: The association between depression after myocardial infarction (post-MI) and increased risk of mortality and cardiac morbidity may be due to cardiac disease severity.

Aims: To combine original data from studies on the association between post-MI depression and prognosis into one database. To investigate to what extent post-MI depression predicts prognosis independently of disease severity.

Method: Individual patient data meta-analysis of studies, using multilevel, multivariable Cox regression analyses.

Results:Sixteen studies participated, creating a database of 10,175 post-MI patients. HRs for post-MI depression were 1.32 (95%CI 1.26-1.38, p

Conclusions: The association between post-MI depression and prognosis is attenuated after adjustment for cardiac disease severity. Still, depression remains independently associated with prognosis, with a 22% increased risk of all-cause mortality and a 13% increased risk of cardiovascular events per standard deviation in depression z-score.

Declaration of interest: None.