0
Grand Rounds |

Depression in Patients Recovering From a Myocardial Infarction

Roy C. Ziegelstein, MD
JAMA. 2001;286(13):1621-1627. doi:10.1001/jama.286.13.1621.
Text Size: A A A
Published online

Depression is common among patients recovering from a myocardial infarction (MI). Approximately 1 in 6 patients with MI experience major depression and at least twice as many as that have significant symptoms of depression soon after the event. Post-MI depression is an independent risk factor for increased mortality. Although the mechanism responsible for this association has not yet been defined, depression is clearly associated with poor compliance with risk-reducing recommendations, with abnormalities in autonomic tone that may make patients more susceptible to ventricular arrhythmias, and with increased platelet activation. Coronary revascularization procedures also appear to be used less often in those with post-MI depression than in comparable patients without mood disorder. Ongoing research will address whether treating depression improves prognosis. Until this question is answered, efforts should focus on enhancing adherence to treatment regimens in this group of patients, who are clearly at risk for noncompliance. Cardiac rehabilitation programs and increasing levels of social support may help improve symptoms and should be recommended to all patients. Treatment of depression itself should be individualized until safety and efficacy are determined for antidepressant therapy in patients who recently have had an MI.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 72

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Resolution

Users' Guides to the Medical Literature
Clinical Scenario

brightcove.createExperiences();