Depression Treatment and Health Status Outcomes in Young Patients With Acute Myocardial Infarction

Abstract

Article, see p 1681; Editorial, see p 1690Depression is common among patients with acute myocardial infarction (AMI) and associated with adverse outcomes. Because depression disproportionately affects women, we examined sex differences in depression treatment rates in young patients with depressive symptoms following AMI admission and evaluated 1-year depressive symptom and health status outcomes by sex and depression treatment status. We evaluated these by using the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), a multicenter, international, prospective cohort study that enrolled patients aged 18 to 55 years (66.8% women).1 VIRGO was approved by Yale’s Institutional Review Board and all patients in the study provided informed consent. We abstracted medical records and conducted in-person interviews to record patient characteristics and used the 9-item Patient Health Questionnaire (PHQ-9)2 to assess depressive symptoms during or shortly after the AMI admission and 1 and 12 months later. Depression treatment was assessed among those with baseline PHQ-9 scores ≥10. Receiving depression treatment was defined as new or continued antidepressant medications or depression counseling at discharge or within at 1 month of discharge.To compare outcomes as a function of depression treatment, we quantified outcomes in those with (1) no significant depressive symptoms (baseline PHQ-9<10); (2) treated depressive symptoms (baseline PHQ-9≥10 and receiving treatment); (3) untreated transient depressive symptoms (baseline PHQ-9≥10 and untreated, …