Lack of a close confidant, but not depression, predicts further cardiac events after myocardial infarction

被引:65
作者
Dickens, CM
McGowan, L
Percival, C
Douglas, J
Tomenson, B
Cotter, L
Heagerty, A
Creed, FH
机构
[1] Univ Manchester, Manchester Royal Infirm, Dept Psychiat, Psychol Med Res Grp, Manchester M13 9WL, Lancs, England
[2] Manchester Royal Infirm, Dept Cardiol, Manchester M13 9WL, Lancs, England
关键词
D O I
10.1136/hrt.2003.011668
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To assess the role of depression and lack of social support before myocardial infarction (MI) in determining outcome in a large representative sample of patients admitted after MI in the UK. Design: Prospective cohort design. Patients: 1034 consecutive patients were screened 3 - 4 days after MI. Main outcome measures: Mortality and further cardiac events over one year after an MI. Results: At 12 months' follow up mortality and further cardiac events were assessed in 583 of 654 eligible patients (90% response); 140 of 589 for whom baseline data were collected (23.8%) were depressed before their MI. Patients who were depressed before their MI were not more likely to die ( mortality 5.2% v 5.0% of non-depressed patients) or suffer further cardiac events ( cardiac events rate 20.7% v 20.3% of non-depressed patients). After controlling for demographic factors and severity of MI, the absence of a close confidant predicted further cardiac events ( hazard ratio 0.57, p = 0.022). Conclusion: Lack of a close confidant but not depression before MI was associated with adverse outcome after MI in this sample. This association may be mediated by unhealthy behaviours and lack of compliance with medical recommendations, but it is also compatible with difficulties in early life leading to heart disease.
引用
收藏
页码:518 / 522
页数:5
相关论文
共 24 条
[11]   Poor adherence to placebo or amiodarone therapy predicts mortality: Results from the CAMIAT study [J].
Irvine, J ;
Baker, B ;
Smith, J ;
Jandciu, S ;
Paquette, M ;
Cairns, J ;
Connolly, S ;
Roberts, R ;
Gent, M ;
Dorian, P .
PSYCHOSOMATIC MEDICINE, 1999, 61 (04) :566-575
[12]   TREATMENT OF MYOCARDIAL INFARCTION IN A CORONARY CARE UNIT - A 2 YEAR EXPERIENCE WITH 250 PATIENTS [J].
KILLIP, T ;
KIMBALL, JT .
AMERICAN JOURNAL OF CARDIOLOGY, 1967, 20 (04) :457-&
[13]   Major depression before and after myocardial infarction: Its nature and consequences [J].
Lesperance, F ;
FrasureSmith, N ;
Talajic, M .
PSYCHOSOMATIC MEDICINE, 1996, 58 (02) :99-110
[14]   Five-year risk of cardiac mortality in relation to initial severity and one-year changes in depression symptoms after myocardial infarction [J].
Lespérance, F ;
Frasure-Smith, N ;
Talajic, M ;
Bourassa, MG .
CIRCULATION, 2002, 105 (09) :1049-1053
[15]   DISTRESS OR ILLNESS - A STUDY OF PSYCHOLOGICAL SYMPTOMS AFTER MYOCARDIAL-INFARCTION [J].
LLOYD, GG ;
CAWLEY, RH .
BRITISH JOURNAL OF PSYCHIATRY, 1983, 142 (FEB) :120-125
[16]  
LLOYD GG, 1980, J ROY COLL PHYS LOND, V14, P224
[17]  
LLOYD GG, 1982, Q J MED, V201, P33
[18]   The relationship of depression to cardiovascular disease -: Epidemiology, biology, and treatment [J].
Musselman, DL ;
Evans, DL ;
Nemeroff, CB .
ARCHIVES OF GENERAL PSYCHIATRY, 1998, 55 (07) :580-592
[19]  
ROSE GA, 1962, B WORLD HEALTH ORGAN, V27, P645
[20]   FACTORS DELAYING TREATMENT OF ACUTE MYOCARDIAL-INFARCTION [J].
SCHWARZ, B ;
SCHOBERBERGER, R ;
RIEDER, A ;
KUNZE, M .
EUROPEAN HEART JOURNAL, 1994, 15 (12) :1595-1598