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Depression ups risk of complications
following Heart Attack
Newswise — People who suffer
from severe depression following a heart
attack might be more likely to experience
cardiac complications while hospitalized,
according to a new study.
“There is good evidence that
if a person has depression after a heart
attack, they are more likely to die from
cardiac causes in the following months and
years,” said lead author Jeff Huffman, M.D.,
assistant professor of psychiatry at Harvard
Medical School.
“No one had yet studied
whether depression impacts cardiac outcomes
immediately after a heart attack—the time we
see the most complications.”
The study included 129
patients at Massachusetts General Hospital.
Within 72 hours of having a heart attack,
each participant underwent an interview to
determine if he or she suffered from
depression or anxiety.
Seventeen of the original
group members had a diagnosis of major
depression lasting for at least two weeks.
The presence of major
depression was a significant predictor of
heart rhythm problems, congestive heart
failure or a second heart attack.
Anxiety did not affect the
risk for any in-hospital complication.
“The results suggest that
physicians should be especially mindful of
treating depression in patients with cardiac
risk factors,” Huffman said.
“They also suggest
close in-hospital monitoring of heart attack
patients with major depression given this
increased risk for complications.”
Huffman noted that the study,
which appears in the July-August issue of
the journal Psychosomatics, is a small,
preliminary study. Most of the participants
were white males, so its findings might not
apply to other groups.
“What is surprising is that
differences in outcomes were seen in a
relatively short time. The new observation
is that risk for these bad outcomes start
while patients are still in the hospital,”
said David Bush, M.D., associate professor
at The Johns Hopkins University School of
Medicine and Heart Institute.
“The separation between heart
disease, typically managed by cardiologists
and internists, and mental disease,
typically managed by psychiatrists, is not
as great as many seem to think.” Bush said.
“Physicians and patients
should be sensitive to this and work on
treating depression in addition to
controlling diabetes, lowering blood
pressure and lowering cholesterol.”
Psychosomatics, the official
journal of the Academy of Psychosomatic
Medicine, publishes peer-reviewed research
and clinical experiences in the practice of
medical-surgical psychiatry. For information
about the journal, contact Ted Stern, M.D.,
at
tstern@partners.org
Huffman JC, et al.
Pre-existing major depression predicts
in-hospital cardiac complications after
acute myocardial infarction. Psychosomatics
49(4), 2008.
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