Systematic Review and Individual Patient Data Meta-Analysis of Sex Differences in Depression and Prognosis in Persons With Myocardial Infarction: A MINDMAPS Study

被引:87
作者
Doyle, Frank [1 ]
Mcgee, Hannah [3 ]
Conroy, Ronn [2 ]
Conradi, Henk Jan [4 ]
Meijer, Anna [5 ]
Steeds, Richard [6 ]
Sato, Hiroshi [7 ]
Stewart, Donna E. [8 ]
Parakh, Kapil [9 ]
Carney, Robert [10 ]
Freedland, Kenneth [10 ]
Anselmino, Matteo [11 ]
Pelletier, Roxanne [12 ]
Bos, Elisabeth H. [5 ]
de Jonge, Peter [5 ]
机构
[1] Royal Coll Surgeons Ireland, Div Populat Hlth Sci Psychol, Dublin 2, Ireland
[2] Royal Coll Surgeons Ireland, Populat Hlth Sci Epidemiol & Publ Hlth Med, Dublin 2, Ireland
[3] Royal Coll Surgeons Ireland, Fac Med & Hlth Sci, Dublin 2, Ireland
[4] Univ Amsterdam, Dept Clin Psychol, NL-1018 WB Amsterdam, Netherlands
[5] Univ Groningen, Univ Med Ctr Groningen, Interdisciplinary Ctr Psychopathol & Emot Regulat, Groningen, Netherlands
[6] Queen Elizabeth Hosp, Dept Cardiol, Birmingham B15 2TH, W Midlands, England
[7] Kwansei Gakuin Univ, Sch Human Welf Studies, Nishinomiya, Hyogo, Japan
[8] Univ Toronto, Univ Hlth Network, Toronto, ON, Canada
[9] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA
[10] Washington Univ, Dept Psychiat, St Louis, MO USA
[11] Univ Turin, Div Cardiol, Dept Med Sci, Turin, Italy
[12] McGill Univ, Ctr Hlth, Montreal, PQ, Canada
来源
PSYCHOSOMATIC MEDICINE | 2015年 / 77卷 / 04期
基金
英国医学研究理事会; 加拿大健康研究院;
关键词
depression; myocardial infarction; gender differences; prognosis; individual patient data meta-analysis; CORONARY-HEART-DISEASE; GENDER-DIFFERENCES; CARDIOVASCULAR EVENTS; ARTERY-DISEASE; RISK-FACTORS; MORTALITY; SYMPTOMS; VULNERABILITIES; RECOMMENDATIONS; ASSOCIATION;
D O I
10.1097/PSY.0000000000000174
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: Using combined individual patient data from prospective studies, we explored sex differences in depression and prognosis post-myocardial infarction (MI) and determined whether disease indices could account for found differences. Methods: Individual patient data analysis of 10,175 MI patients who completed diagnostic interviews or depression questionnaires from 16 prospective studies from the MINDMAPS study was conducted. Multilevel logistic and Cox regression models were used to determine sex differences in prevalence of depression and sex-specific effects of depression on subsequent outcomes. Results: Combined interview and questionnaire data from observational studies showed that 36% (635/1760) of women and 29% (1575/5526) of men reported elevated levels of depression (age-adjusted odds ratio = 0.68, 95% confidence interval [CI] = 0.60-0.77). The risk for all-cause mortality associated with depression was higher in men (hazard ratio = 1.38, 95% CI = 1.30-1.47) than in women (hazard ratio = 1.22, 95% CI = 1.14-1.31; sex by depression interaction: p < .001). Low left ventricular ejection fraction (LVEF) was associated with higher depression scores in men only (sex by LVEF interaction: B = 0.294, 95% CI = 0.090-0.498), which attenuated the sex difference in the association between depression and prognosis. Conclusions: The prevalence of depression post-MI was higher in women than in men, but the association between depression and cardiac prognosis was worse for men. LVEF was associated with depression in men only and accounted for the increased risk of all-cause mortality in depressed men versus women, suggesting that depression in men post-MI may, in part, reflect cardiovascular disease severity.
引用
收藏
页码:419 / 428
页数:10
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