Increased Risk of Myocardial Infarction in Depressed Patients With Type 2 Diabetes
Open Access
- 16 July 2011
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 34 (8), 1729-1734
- https://doi.org/10.2337/dc11-0031
Abstract
OBJECTIVE: To investigate major depressive disorder (MDD), which complicates the course of type 2 diabetes and is associated with an increased risk of cardiovascular disease and death. This risk may be due to a greater susceptibility for myocardial infarction (MI) in depressed patients with type 2 diabetes compared with nondepressed patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Veterans Administration electronic medical records were analyzed to identify a cohort free of cardiovascular disease in fiscal years 1999 and 2000, aged 25 to 80 years. ICD-9-CM codes were used to create a four-level risk group indicating 1) neither diabetes nor MDD (n = 214,749), 2) MDD alone (n = 77,568), 3) type 2 diabetes alone (n = 40,953), and 4) comorbid MDD and type 2 diabetes (n = 12,679). Age-adjusted Cox proportional hazards models were computed before and after adjusting for baseline sociodemographic and time-dependent covariates. RESULTS: After adjusting for covariates, patients with type 2 diabetes alone and patients with MDD alone were at ∼30% increased risk for MI, and patients with type 2 diabetes and MDD were at 82% increased risk for MI (hazard ratio 1.82 [95% CI 1.69–1.97]) compared with patients without either condition. CONCLUSIONS: Compared with patients with only diabetes or only MDD, individuals with type 2 diabetes and MDD are at increased risk for new-onset MI. Monitoring cardiovascular health in depressed patients with type 2 diabetes may reduce the risk of MI in this especially high-risk group.Keywords
This publication has 25 references indexed in Scilit:
- Collaborative Care for Patients with Depression and Chronic IllnessesNew England Journal of Medicine, 2010
- Anxiety disorders increase risk for incident myocardial infarction in depressed and nondepressed Veterans Administration patientsAmerican Heart Journal, 2010
- Cardiovascular Disease in Type 2 Diabetes From Population to Man to MechanismsDiabetes Care, 2010
- Depression and Advanced Complications of DiabetesDiabetes Care, 2009
- Depression and Increased Mortality in Diabetes: Unexpected Causes of DeathAnnals of Family Medicine, 2009
- Are Claims Data Accurate Enough to Identify Patients for Performance Measures or Quality Improvement? The Case of Diabetes, Heart Disease, and DepressionAmerican Journal of Medical Quality, 2006
- Depression Diagnosis and Antidepressant Treatment among Depressed VA Primary Care PatientsAdministration and Policy in Mental Health and Mental Health Services Research, 2006
- Treating Depression to Prevent Diabetes and Its Complications:Understanding Depression as a Medical Risk FactorClinical Diabetes, 2006
- A prospective study of depression and mortality in patients with type 2 diabetes: the Fremantle Diabetes StudyDiabetologia, 2005
- Who Has Diabetes? Best Estimates of Diabetes Prevalence in the Department of Veterans Affairs Based on Computerized Patient DataDiabetes Care, 2004