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Initiation of statin therapy after acute myocardial infarction is not associated with worsening depressive symptoms: Insights from the Prospective Registry Evaluating Outcomes After Myocardial Infarctions: Events and Recovery (PREMIER) and Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH) registries.
Am Heart J. 2013 Nov;166(5):879-86
Authors: Al Badarin FJ, Spertus JA, Gosch KL, Buchanan DM, Chan PS
Abstract
BACKGROUND: Whereas statins are considered the cornerstone of prevention after acute myocardial infarction (AMI), concerns about worsening depression in association with their use have been raised.
METHODS: Using data from 2 prospective AMI registries (PREMIER and TRIUMPH), we examined the change in depressive symptoms from baseline and at 1, 6 and 12 months among statin-naïve patients who were and were not discharged on a statin. Depressive symptoms were assessed with the 8-item Patient Health Questionnaire (PHQ-8). Within-group change in PHQ-8 scores from baseline to each follow-up period was assessed using paired t tests. A repeated-measures propensity-matched analysis examined whether changes in PHQ-8 scores from baseline were different between statin-treated and statin-untreated patients.
RESULTS: Of 3,675 patients not previously treated with statins, 3,050 (83%) were discharged on a statin and 625 (17%) were not. Scores of PHQ-8 in the statin group decreased from baseline by a mean (±SD) of 0.9 (±5.1), 1.2 (±5), and 1.1 (±5.1) at 1, 6, and 12 months, respectively. Corresponding changes in the nonstatin group were 0.9 (±5.2), 1.3 (±5.1), and 1.5 (±5.8), respectively (P < .0001 for all comparisons). After propensity matching, 451 patients not discharged on statins with 1,240 patients discharged on statins, the mean change in PHQ-8 scores between baseline and the 3 follow-up time points was not significantly different between groups (mean between-group difference at 1 month: -0.13, 95% CI [-0.69 to 0.43], P = .65; at 6 months: -0.07, 95% CI [-0.66 to 0.52], P = .82; and at 12 months: -0.05, 95% CI [-0.67 to 0.58], P = .88).
CONCLUSIONS: Initiation of statins after AMI was not associated with worsening depression.
PMID: 24176444 [PubMed - in process]