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Developing depression after a myocardial infarction increases risk of cardiac mortality but pre-existing depression does not

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Does the association between depression and cardiac mortality differ between people with pre- and post-myocardial infarction depression?


588 adults (mean age 60.0 (SD 11.1) years; 70% male) admitted to hospital with suspected myocardial infarction (MI) who were found to meet WHO criteria for MI plus two of the following on screening: characteristic ECG changes, history of typical chest pain or serial increase in creatine phosphokinase (CPK) to twice or more the normal limits. Exclusion criteria were: serious comorbidities, too unwell to complete assessment, aged 80 years or older, limited spoken English or lived outside the catchment area.


Four inner city hospitals, UK; screening October 1997–November 1999.

Prognostic factors:

The main factor of interest was depression and its time of onset, either pre-MI or post-MI. At baseline, participants completed the Hospital Anxiety and Depression Scale (HADS) on their mental state in the week before the MI and then again at 12 months after their MI. Depression …

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  • Source of funding: Medical Research Council, UK, the British Heart Foundation and the University of Manchester, Manchester, UK.

  • ▸ Tables 1 and 2, and a reference list are published online only at


  • Competing interests: None.

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