PMCC PMCC

Search tips
Search criteria

Advanced
Results 1-2 (2)
 

Clipboard (0)
None
Journals
Authors
Year of Publication
Document Types
1.  Depressive Symptoms and Risk of New Cardiovascular Events or Death in Patients with Myocardial Infarction: A Population-Based Longitudinal Study Examining Health Behaviors and Health Care Interventions 
PLoS ONE  2013;8(9):e74393.
Background
Depressive symptoms is associated with adverse cardiovascular outcomes in patients with myocardial infarction (MI), but the underlying mechanisms are unclear and it remains unknown whether subgroups of patients are at a particularly high relative risk of adverse outcomes. We examined the risk of new cardiovascular events and/or death in patients with depressive symptoms following first-time MI taking into account other secondary preventive factors. We further explored whether we could identify subgroups of patients with a particularly high relative risk of adverse outcomes.
Methods and Results
We conducted a prospective population-based cohort study of 897 patients discharged with first-time MI between 1 January 2009 and 31 December 2009, and followed up until 31 July 2012. Depressive symptoms were found in 18.6% using the Hospital Anxiety and Depression Scale (HADS-D≥8). A total of 239 new cardiovascular events, 95 deaths, and 288 composite events (239 new cardiovascular events and 49 deaths) occurred during 1,975 person-years of follow-up. Event-free survival was evaluated using Cox regression analysis. Compared to the 730 patients without depressive symptoms (HADS-D<8), the 167 patients with depressive symptoms (HADS-D≥8) had age- and sex-adjusted hazard ratios [HR] (95% confidence interval [CI]) of 1.53 (95% CI, 1.14–2.05) for a new cardiovascular event, 3.10 (95% CI, 2.04–4.71) for death and 1.77 (95% CI, 1.36–2.31) for a composite event. The associations were attenuated when adjusted for disease severity, comorbid conditions and physical inactivity; HR = 1.17 (95% CI, 0.85–1.61) for a new cardiovascular event, HR = 2.01 (95% CI, 1.28–3.16) for death, and HR = 1.33 (95% CI, 1.00–1.76) for a composite event. No subgroups of patients had a particularly high risk of adverse outcomes.
Conclusions
Depressive symptoms following first-time MI was an independent prognostic risk factor for death, but not for new cardiovascular events. We found no subgroups of patients with a particularly high relative risk of adverse outcomes.
doi:10.1371/journal.pone.0074393
PMCID: PMC3783427  PMID: 24086339
2.  Rehabilitation status three months after first-time myocardial infarction 
Objective
To describe the rehabilitation status three months after first-time myocardial infarction (MI) to identify focus areas for long-term cardiac rehabilitation (CR) in general practice.
Design
Population-based cross-sectional study.
Setting and subjects
Patients with first-time MI in 2009 from the Central Denmark Region. Data were obtained from patient questionnaires and from registers.
Results
Of the 1288 eligible patients, 908 (70.5%) responded. The mean (SD) age was 67.1 (11.7) years and 626 (68.9%) were men. Overall, 287 (31.6%) of the patients lived alone and 398 (45.4%) had less than 10 years of education. Upwards of half (58.5%) of the patients stated that they had participated in hospital-based rehabilitation shortly after admission. A total of 262 (29.2%) were identified with anxiety or depressive disorder or both, according to the Hospital Anxiety and Depression Scale. Of these, 78 (29.8%) reported that they had participated in psychosocial support, and 55 (21.0%) used antidepressants. One in five patients smoked three months after MI although nearly half of the smokers had stopped after the MI. Regarding cardioprotective drugs, 714 (78.6%) used aspirin, 694 (76.4%) clopidogrel, 756 (83.3%) statins, and 735 (81.0%) beta-blockers.
Conclusion
After three months, there is a considerable potential for further rehabilitation of MI patients. In particular, the long-term CR should focus on mental health, smoking cessation, and cardioprotective drugs.
doi:10.3109/02813432.2011.629147
PMCID: PMC3308468  PMID: 22126219
Depression; drug therapy; family practice; myocardial infarction; rehabilitation; smoking

Results 1-2 (2)