News Release: Research, School of Medicine

Feb. 24,  2009

Depression Increases Poor Outcome Risk for Women Following Heart Attack

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Depression is common among patients recovering from heart attack or myocardial infarction (MI) and research shows depressive symptoms predict adverse post-MI outcomes. Women have unexplained worse outcomes following heart attack compared to men.

A study reported by Emory University researchers examined whether depressive symptoms account for the increased risk in women recovering from MI.

"Our study findings show that depressive symptoms are common, adversely affect prognosis and can be effectively recognized and treated in cardiac patients," says principal investigator Susmita Parashar, MD, MPH, a member of the cardiology division at the Emory University School of Medicine who treats patients at Grady Memorial Hospital.

Myocardial infarction (MI), often referred to as a heart attack, occurs when the blood supply to part of the heart is interrupted. This decreased blood supply is commonly due to blockage of a coronary artery and if left untreated can cause damage and or death of heart muscle tissue. Coronary heart disease claims the lives of more than a half million women every year in the United States.

Between January 2003 and June 2004, 2,498 patients from 19 US hospitals participated in the “Prospective Registry Evaluating Outcomes After Myocardial Infarction: Events and Recovery (PREMIER)” study. Of those eligible participants in the final group of 2,411 MI patients 807 were women. Parashar and her team assessed depressive symptoms using the Patient Health Questionnaire. Outcomes included one-year re-hospitalization, angina characterized by the Seattle Angina Questionnaire and two-year mortality.

Initially, researchers noted depressive symptoms were more prevalent in women compared with men 29 percent versus 18.8 percent respectively. After adjusting for demographic factors, medical conditions, MI severity and quality of care, women had only a slight higher risk of re-hospitalization at 6 percent. While researchers noted no increased risk of mortality between the two groups, women had a 10 percent greater risk of angina compared to men.

"We found depressive symptoms contributed 10 percent higher absolute risk of angina in women," says Parashar. "This is clinically important because angina symptoms affect women’s survival rates, functional status, quality of life and health related costs."

The study was published January 2009 issue of Circulation: Cardiovascular Quality and Outcomes. Parashar says it supports recent recommendations to improve recognition of depressive symptoms after myocardial infarction.

Reference: "Impact of Depression on Sex Differences in Outcome After Myocardial Infarction.” Parashar, Susmita MD, MPH, MS et al. Circulation:  Cardiovascular Quality and Outcomes January 2009 pp 33-40.


The Robert W. Woodruff Health Sciences Center of Emory University is an academic health science and service center focused on missions of teaching, research, health care and public service. Its components include schools of medicine, nursing, and public health; Yerkes National Primate Research Center; the Emory Winship Cancer Institute; and Emory Healthcare, the largest, most comprehensive health system in Georgia. The Woodruff Health Sciences Center has a $2.3 billion budget, 17,000 employees, 2,300 full-time and 1,900 affiliated faculty, 4,300 students and trainees, and a $4.9 billion economic impact on metro Atlanta.

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