Levels of anxiety and depression as predictors of mortality following myocardial infarction: A 5-year follow-up

Background: Post-myocardial infarction (MI) depression is a highly prevalent disorder, affecting nearly 18% of all MI patients, and it is a major predictor of disability in the year post-MI. We sought to expand this analysis by: comparing case-level anxiety, depression, and comorbid anxiety and depression as predictors of long term mortality during a 5-year follow-up period after MI; and investigating the role of potential modifying and confounding factors. Methods: A total of 285 patients were screened on average 6 days after their MI and a 5-year survival rate was ascertained. The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were completed by patients hospitalized for MI. In addition we tested the BDI x STAI interaction effect. Results: During the 5 years of follow-up, cardiac mortality was assessed in 274 of 285 eligible patients. Of the 274 patients whose survival data were available, 91 (33.2%) died. At entry, BDI score of 192 (67.4%) patients was >= 10 and 145 (50.9%) patients had STAI score >= 40. Anxiety was not associated with mortality, whereas depression significantly predicted death, but this association was attenuated to non-significance with full adjustment with disease severity and confounders. Conclusions: Depression following MI does not predict longer-term survival with full adjustment.