The association between cardiac rehabilitation and mortality risk for myocardial infarction patients with and without depressive symptoms - PubMed (original) (raw)
Randomized Controlled Trial
doi: 10.1016/j.jad.2015.08.057. Epub 2015 Sep 2.
Affiliations
- PMID: 26384014
- DOI: 10.1016/j.jad.2015.08.057
Randomized Controlled Trial
The association between cardiac rehabilitation and mortality risk for myocardial infarction patients with and without depressive symptoms
Maaike Meurs et al. J Affect Disord. 2015.
Abstract
Background: Post-myocardial infarction (MI) depression is associated with reduced adherence to cardiac rehabilitation (CR) and increased mortality risk. The present study investigated whether all-cause mortality reduction associated with CR is different for MI-patients with and without depressive symptoms.
Methods: Data of 2198 post-MI patients from the Depression after Myocardial Infarction (DepreMI) study and Myocardial Infarction and Depression Intervention Trial (MIND-IT) was used. Depression was assessed at hospitalization, defined as a score≥10 on the Beck Depression Inventory (BDI). Participation in CR was assessed with a self-report questionnaire, 12 months post-MI. Cox regression was used to estimate hazard ratios (HR) for all-cause mortality, up till 10 years post-MI. Missing data was imputed, using multiple imputation.
Results: 878 (52%) Patients attended CR, 517 (26%) patients had a BDI score ≥10, and 379 (18%) patients died during the follow-up period. Overall, CR was not associated with a lower mortality risk (HR: 0.83; 0.54-1.30; p=0.41), adjusted for age, sex, left ventricle ejection fraction, previous MI, and past or current heart failure. However, there was a significant interaction between depression and CR on mortality (HR: 0.49; 0.27-0.90; p=0.02). CR was significantly associated with reduced mortality in depressed patients (HR: 0.48; 0.28-0.84; p=0.01), but not in non-depressed patients (HR: 1.09; 0.63-1.89; p=0.74).
Limitations: Patients were not randomized to CR. We had no information about the specific reasons of clinicians to offer CR and about the patients' motives to participate.
Conclusions: CR was associated with reduced mortality risk only for MI-patients with depression. Clinicians should therefore particularly encourage MI-patients with depression to participate in CR.
Keywords: Cardiac rehabilitation; Depression; Mortality; Myocardial infarction (MI); Prognosis.
Copyright © 2015 Elsevier B.V. All rights reserved.
Similar articles
- Self-reported depressive symptoms, diagnosed clinical depression and cardiac morbidity and mortality after myocardial infarction.
Zuidersma M, Conradi HJ, van Melle JP, Ormel J, de Jonge P. Zuidersma M, et al. Int J Cardiol. 2013 Sep 10;167(6):2775-80. doi: 10.1016/j.ijcard.2012.07.002. Epub 2012 Jul 24. Int J Cardiol. 2013. PMID: 22835990 Clinical Trial. - Individual depressive symptoms and all-cause mortality In 6673 patients with myocardial infarction: Heterogeneity across age and sex subgroups.
de Miranda Azevedo R, Roest AM, Carney RM, Freedland KE, Lane DA, Parakh K, de Jonge P, Denollet J. de Miranda Azevedo R, et al. J Affect Disord. 2018 Mar 1;228:178-185. doi: 10.1016/j.jad.2017.11.025. Epub 2017 Nov 16. J Affect Disord. 2018. PMID: 29253684 - Course of depressive symptoms after myocardial infarction and cardiac prognosis: a latent class analysis.
Kaptein KI, de Jonge P, van den Brink RH, Korf J. Kaptein KI, et al. Psychosom Med. 2006 Sep-Oct;68(5):662-8. doi: 10.1097/01.psy.0000233237.79085.57. Epub 2006 Sep 20. Psychosom Med. 2006. PMID: 16987947 - Depression, stroke, and dementia in patients with myocardial infarction.
Sundbøll J. Sundbøll J. Dan Med J. 2018 Apr;65(4):B5423. Dan Med J. 2018. PMID: 29619929 Review.
Cited by
- Causal Model Building in the Context of Cardiac Rehabilitation: A Systematic Review.
Akbari N, Heinze G, Rauch G, Sander B, Becher H, Dunkler D. Akbari N, et al. Int J Environ Res Public Health. 2023 Feb 11;20(4):3182. doi: 10.3390/ijerph20043182. Int J Environ Res Public Health. 2023. PMID: 36833877 Free PMC article. Review. - Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine: Update of the Cardiac Rehabilitation Outcome Study (CROS-II).
Salzwedel A, Jensen K, Rauch B, Doherty P, Metzendorf MI, Hackbusch M, Völler H, Schmid JP, Davos CH. Salzwedel A, et al. Eur J Prev Cardiol. 2020 Nov;27(16):1756-1774. doi: 10.1177/2047487320905719. Epub 2020 Feb 23. Eur J Prev Cardiol. 2020. PMID: 32089005 Free PMC article. - Do Cardiac Rehabilitation Affect Clinical Prognoses Such as Recurrence, Readmission, Revascularization, and Mortality After AMI?: Systematic Review and Meta-Analysis.
Kim C, Choi I, Cho S, Kim AR, Kim W, Jee S. Kim C, et al. Ann Rehabil Med. 2021 Feb;45(1):57-70. doi: 10.5535/arm.20080. Epub 2021 Feb 9. Ann Rehabil Med. 2021. PMID: 33557486 Free PMC article. - Residual Symptoms After Treatment for Depression in Patients With Coronary Heart Disease.
Carney RM, Freedland KE, Steinmeyer BC, Rubin EH, Rich MW. Carney RM, et al. Psychosom Med. 2018 May;80(4):385-392. doi: 10.1097/PSY.0000000000000570. Psychosom Med. 2018. PMID: 29521883 Free PMC article. - The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy: A systematic review and meta-analysis of randomized and non-randomized studies - The Cardiac Rehabilitation Outcome Study (CROS).
Rauch B, Davos CH, Doherty P, Saure D, Metzendorf MI, Salzwedel A, Völler H, Jensen K, Schmid JP; ‘Cardiac Rehabilitation Section’, European Association of Preventive Cardiology (EAPC), in cooperation with the Institute of Medical Biometry and Informatics (IMBI), Department of Medical Biometry, University of Heidelberg, and the Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice, Heinrich-Heine University, Düsseldorf, Germany. Rauch B, et al. Eur J Prev Cardiol. 2016 Dec;23(18):1914-1939. doi: 10.1177/2047487316671181. Epub 2016 Oct 25. Eur J Prev Cardiol. 2016. PMID: 27777324 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous