Diabetes patients at increased risk for MI if clinically depressed
MedWire News: Individuals with Type 2 diabetes complicated by comorbid major depressive disorder (MDD) are more likely to have a myocardial infarction (MI) than patients with neither or just one of these conditions, research shows.
The study of nearly 1.4 million patients revealed that those with both diabetes and MDD had an 82% greater risk for new-onset MI than patients with neither condition, while those with either diabetes or MDD alone had around a 30% greater risk.
Jeffery Scherrer (St Louis Veterans Affairs Medical Center, Missouri, USA) and colleagues identified a cohort of patients free of cardiovascular disease (CVD) using the national Veteran's Administration (VA) medical records. They then compared the risk for MI among four risk groups comprising patients with: neither diabetes nor MDD; MDD alone; diabetes alone; or both diabetes and MDD.
As reported in the journal Diabetes Care, the results of the 7-year follow-up showed that the incidence of MI increased in a stepwise fashion from 2.6% in unaffected patients to 3.5% in patients with MDD only, 5.9% in patients with diabetes only, and 7.4% in patients with both conditions.
Further analysis revealed that older age, being male, being White and being unmarried were demographic risk factors for new-onset MI, along with behavioral risk factors. "MDD may impair Type 2 diabetes self-care and increase physical inactivity and other behavioral risk factors such as smoking and obesity," explain the authors.
They say their findings are consistent with evidence that MDD in Type 2 diabetes not only complicates the course of the condition, but is also an independent contributor to CVD. They conclude that monitoring cardiovascular health in this especially high-risk group may improve clinical outcomes in these patients.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Sally Robertson