Depression follows Myocardial Infarction

Unfortunately, depression is now a well documented independent risk factor of coronary artery disease. Post-myocardial infarction (MI) patients with a clinician-diagnosed depressive disorder or self-reported depressive symptoms carry a 2.0to 2.5-fold increased relative risk of new cardiovascular events and cardiac mortality Questions about the pathophysiologic mechanism of depression in this setting are paralleled by uncertainties about the optimal treatment of depression for patients recovering from a myocardial infarction and by a lack of knowledge about whether treating depression lowers the associated increased mortality risk. Ongoing research studies will help to determine the benefits of psychosocial interventions and of antidepressant therapy for patients soon after myocardial infarction. Although the identification of depression as a risk factor may by itself be a reason to incorporate a comprehensive psychological evaluation into the routine care of patients with myocardial infarction. This practice should certainly become standard if studies show that treating depression reduces the increased mortality risk of these patients. Treatment with selective serotonin reuptake inhibitors (SSRIs) significantly improved outcome of what one can become a major catastrophe (Jonge et al). Although non-randomized trial, this could essentially relate to intrinsic pharmacologic properties of SSRIs causing, for example, restoration of subtle platelet hyperactivity in the depressed. Clearly, before another clinical trial of depression treatment is initiated in post-MI populations, we need more information on the “cardio toxic” subtypes of depression. But the query still persists. Keeping all these chronic outbursts in mind a study was conducted on indoor and outdoor patients attending or admitted in GGS Medical College & Hospital, Faridkot. 67 MI diagnosed and treated patients attending the post MI clinics were interviewed for symptoms of depression. We investigated if there are differences in preand post-MI characteristics between these subtypes. Persons who are depressed and who have pre-existing cardiovascular disease have a 3.5 times greater risk of death than patients who are not depressed and have cardiovascular disease. A comparison was made between first-ever and ongoing or recurrent depression on demographic and cardiac data, personality, and depression characteristics Results: Approximately 165 percent of patients with acute myocardial infarction report experiencing symptoms of depression in a structured study. Major depression is present in 15 to 22 percent of these patients. Depression is an independent risk factor in the development of and mortality associated with cardiovascular disease in otherwise healthy persons. Cognitive-behavior therapy is the preferred psychological treatment. Selective serotonin reuptake inhibitor antidepressants are the recommended pharmacologic treatment because of the relative absence of effects on the cardiovascular system. The combination of a selective serotonin reuptake inhibitor with cognitive-behavior therapy is often the most effective treatment for depression in patients with cardiovascular disease. BioMedSciDirect Publications International Journal of BIOLOGICAL AND MEDICAL RESEARCH www.biomedscidirect.com Int J Biol Med Res Volume 3, Issue 1, Jan 2012