Depression during hospitalization for acute coronary syndrome predicts physical function one year later

Abstract

Background and aims:

Although much attention has been paid to predictors of mortality after an acute myocardial infarction (MI), patients are at least as concerned with their physical function (PF). One study found no relationship between depression at the time of MI and PF 4 months later, whereas another reported a relationship at 6 months but not at 12 months. We assessed whether symptoms of depression assessed in-hospital predict overall PF 12 months later.

Methods:

Prospective observational study of 484 patients with MI or unstable angina assessed with the Beck Depression Inventory (BDI) and SF-12 Health Survey during hospitalization and with the SF-12 Health Survey 12 months later. Linear regression was used to predict the overall SF-12 PF score at 12 months, controlling for baseline PF score and for age, gender, Killip class, history of MI, diagnosis (MI vs unstable angina), and BDI score.

Results:

At the time of the index hospitalization, 151 patients (31.2%) scored 10 or greater on the BDI. Mean (± SD) T score for the PF subscale of the SF-12 was 41.4 ± 11.4 in-hospital and 41.7 ± 11.6 12 months later. Significant predictors of 12-month PF score were age (p <.001), female gender (p = .005), baseline PF score (p < .001), and BDI score (p < .001).

Conclusions:

Older age, female gender, and symptoms of depression are important predictors of 12-month PF after controlling for baseline PF. Consistent with other studies, other clinical characteristics do not appear to predict PF during recovery.