Clinical depression and anxiety among ST-elevation myocardial infarction hospitalizations: Results from Nationwide Inpatient Sample 2004–2013. (August 2018)

• Record Type: Journal Article
• Authors: Pino, Elizabeth C; Zuo, Yi; Borba, Christina PC; Henderson, David C; Kalesan, Bindu
• Is Part Of: Psychiatry research. Volume 266(2018)
• Page Start: 291
• Page End: 300
• Publication Date: 2018-08
• Subjects: Myocardial infarction -- Depression -- Anxiety -- Revascularization; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2018.03.025
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: The odds of in-hospital mortality were lower among STEMI hospitalizations with co-diagnosis of depression/anxiety as compared to those without. Diagnoses of depression and/or anxiety were less prevalent among revascularized as compared to non-revascularized STEMI hospitalizations. The rate of diagnoses of depression/anxiety among STEMI hospitalizations increased at a similar rate irrespective of revascularization status. Abstract: Depression and anxiety are common among patients who have a major cardiovascular event. However, despite their frequency, there is a lack of evidence regarding the relationship between depression and/or anxiety and receiving revascularization in ST-elevation myocardial infarction (STEMI) hospitalizations. Using data from the Nationwide Inpatient Sample (NIS) from the years 2004 to 2013, we assessed whether a clinical co-diagnosis of depression and/or anxiety decreases the likelihood of revascularization among STEMI hospitalizations. Our central finding is that, paradoxically, the odds of in-hospital mortality were lower among STEMI hospitalizations with a clinical co-diagnosis of depression and/or anxiety as compared to those without. We further discovered that clinical diagnoses of depression and/or anxiety were less prevalent among revascularized as compared to non-revascularized STEMI hospitalizations. However, the percentage of clinical diagnoses of depression and/or anxiety among STEMI hospitalizations increased at a similar rate over a 10-year period irrespective of revascularization status. In conclusion, these results are suggestive of the potentially underdiagnosed mental health issues surrounding major cardiovascular events, and indeed, chronic disease as a whole. To our knowledge, this is the first study to document and examine the "depression paradox" among a population of cardiac patients.