Depression after heart attack shouldn't be ignored

People who are depressed after a heart attack fare worse than those who don't suffer from a bout of depression, even if their symptoms are only temporary, a new study shows.

It's crucial for patients, their loved ones and their doctors to understand that being depressed after a heart attack isn't "normal," and shouldn't be ignored, Dr. Susmita Parashar of the Emory School of Medicine in Atlanta, the study's lead author, told Reuters Health.

"Depressive symptoms, whether they are transient, persistent, or new, are actually more consistently associated with worse outcomes compared with traditional measures of disease severity," Parashar added in an interview.

About one in five people who have a heart attack suffer from depression while hospitalized or in the first year following their heart attack, the researchers point out in the Archives of Internal Medicine. But many people, including physicians, see this as a normal reaction to a serious illness, and there is a perception that transient depression will have no lasting effect on a patient's health.

To investigate, Parashar's group looked at how 1,873 patients fared six months after having a heart attack. During hospitalization, 20.6 percent experienced moderate to severe depression, while 13.1 percent were depressed one month after hospital discharge. Seven percent of patients were depressed at both time points, and were classified as having persistent depression, while 13.5 percent were only depressed in the hospital (transient depression) and 6 percent became depressed for the first time after hospital discharge (new depression).

At six months, all of the depressed patients were more likely to have been re-hospitalized or to have died than the 73.5 percent of patients who reported no depression. The depressed patients also experienced more chest pain, more disability, and worse quality of life.

In fact, the researchers found, depression was a better predictor of patient outcome than traditionally used measures such as left ventricular ejection fraction - a gauge of the heart's pumping power - or a patient's past history of heart attack.

Future research is needed, Parashar said, to determine if treating depression in heart attack patients can help improve outcome.

SOURCE: Archives of Internal Medicine, October 9, 2006.