Emory Report
March 2, 2009
Volume 61, Number 22



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March 2
, 2009
Depression symptoms raise risk for women after heart attack

By Juliette Merchant

Women have unexplained worse outcomes after heart attack compared to men. Because depression is common among patients recovering from heart attack, Emory researchers explored whether depressive symptoms account for the increased risk in women.

“Our study findings showed that depressive symptoms are common, adversely affect prognosis and can be effectively recognized and treated in cardiac patients,” says principal investigator Susmita Parashar, a member of the cardiology division at Emory University School of Medicine who treats patients at Grady Memorial Hospital.

Myocardial infarction (MI), often referred to as a heart attack, occurs when the blood supply to part of the heart is interrupted. This decreased blood supply is commonly due to blockage of a coronary artery and if left untreated can cause damage and or death of heart muscle tissue. Heart disease claims the lives of more than a half million women every year in the United States.

Between January 2003 and June 2004, 2,411 patients (807 women, 1,604 men) from 19 U.S. hospitals participated in the PREMIER study (Prospective Registry Evaluating Outcomes After Myocardial Infarction: Events and Recovery). Parashar and her team assessed depressive symptoms using the Patient Health Questionnaire. Outcomes included one-year re-hospitalization, angina characterized by the Seattle Angina Questionnaire and two-year mortality.

Initially, researchers noted depressive symptoms were more prevalent in women compared with men: 29 percent versus 18.8 percent. After adjusting for demographic factors, medical conditions, MI severity and quality of care, women had only a slightly higher risk of re-hospitalization at 6 percent. While researchers noted no increased risk of mortality between the two groups, women had a 10 percent greater risk of angina compared to men.

“We found depressive symptoms contributed 10 percent higher absolute risk of angina in women,” says Parashar. “This is clinically important because angina symptoms affect women’s survival rates, functional status, quality of life and health-related costs.”

The study was published in the January 2009 issue of Circulation: Cardiovascular Quality and Outcomes. Parashar says it supports recent recommendations to improve recognition of depressive symptoms after heart attack.