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The long-term risk of recognized and unrecognized myocardial infarction for depression in older men

Published online by Cambridge University Press:  21 March 2016

O. Jovanova ,
A. I. Luik ,
M. J. G. Leening ,
R. Noordam ,
N. Aarts ,
A. Hofman ,
O. H. Franco ,
A. Dehghan  and
H. Tiemeier
O. Jovanova
Affiliation:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
A. I. Luik
Affiliation:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
M. J. G. Leening
Affiliation:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
R. Noordam
Affiliation:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
N. Aarts
Affiliation:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
A. Hofman
Affiliation:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
O. H. Franco
Affiliation:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
A. Dehghan
Affiliation:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
H. Tiemeier*
Affiliation:
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
*
*Address for correspondence: H. Tiemeier, MD, PhD, Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. (Email: [email protected])
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Abstract

Background

The association between myocardial infarction (MI) and depression is well described. Yet, the underlying mechanisms are unclear and the contribution of psychological factors is uncertain. We aimed to determine the risk of recognized (RMI) and unrecognized (UMI) myocardial infections on depression, as both have a similar impact on cardiovascular health but differ in psychological epiphenomena.

Method

Participants of the Rotterdam Study, 1823 men aged ⩾55 years, were followed for the occurrence of depression. RMI and UMI were ascertained using electrocardiography and medical history at baseline. We determined the strength of the association of RMI and UMI with mortality, and we studied the relationship of RMI and UMI with depressive symptoms and the occurrence of major depression.

Results

The risk of mortality was similar in men with RMI [adjusted hazard ratio (aHR) 1.71, 95% confidence interval (CI) 1.45–2.03] and UMI (aHR 1.58, 95% CI 1.27–1.97). Men with RMI had on average [unstandardized regression coefficient (B) 1.14, 95% CI 0.07–2.21] higher scores for depressive symptoms. By contrast, we found no clear association between UMI and depressive symptoms (B 0.55, 95% CI −0.51 to 1.62) in men. Analysis including occurrence of major depression as the outcome were consistent with the pattern of association.

Conclusion

The discrepant association of RMI and UMI with mortality compared to depression suggests that the psychological burden of having experienced an MI contributes to the long-term risk of depression.

Keywords

Depressionepidemiologymyocardial infarctionpopulation based
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 9 , July 2016 , pp. 1951 - 1960
Copyright
Copyright © Cambridge University Press 2016 

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