Abstract 138: Characterizing Depressed Symptoms in Younger Women and Men Who Experienced an Acute Myocardial Infarction: Insights from the VIRGO Study

Abstract

Background: This study aimed to determine the prevalence of the depressive symptom burden among younger men and women, and to better characterize those experiencing depressive symptoms in the weeks leading up to their AMI. Method: The VIRGO study enrolled 3,572 AMI patients (2:1 ratio for women: men; 67.1% women) between 2008 and 2012 (103 US hospitals, 24 in Spain and 3 in Australia) at their index AMI admission. The PHQ-9 (clinically relevant depressive symptoms = PHQ-9 scores ≥10) was administered to assess patients’ depressive symptoms. Demographic, socio-economic, cardiovascular risk, AMI risk factor, perceived stress (PSS-14), and health status information (Seattle Angina Questionnaire [SAQ], EQ-5D) was obtained through patient interviews during the index hospitalization and medical chart abstraction. Information about history of depression was also documented through interviews. Results: A total of 886 (39%) women experienced clinically relevant depressive symptoms vs. 245 (22%) men (P<0.0001). Overall, about half (n=1141, 48%) of women reported a prior history of depression vs. 1 in 4 in men (n=280, 24%) (P<0.0001). Women had higher rates of somatic depressive symptoms (10% vs. 6% in men), as well as a combination of cognitive and somatic symptoms of depression (23% vs. 11% in men) (P<0.0001). High levels of stress (mean score 32±8 vs. 21±8 for men; 34±8 vs. 23±8 for women on PSS-14) and low quality of life scores (mean SAQ Quality of Life score 50±22 vs. 63±21 for men; 45±25 vs. 61±22 for women) were noted among depressed patients, regardless of their gender (all P-values <0.0001 for depressed vs. non-depressed). In both women and men, depression was more prevalent among patients with a lower socio-economic profile (e.g. lower education, uninsured), among those with cardiovascular risk factors (e.g. diabetes, smoking). As compared with men, women had a 2.28-increased odds of experiencing depressive symptoms. This relationship persisted after adjusting for demographic, socio-economic, cardiovascular and AMI risk factors, and health status (OR=1.64; 95%CI 1.36, 1.98). Conclusions: A high depressive symptom burden and prior history of depression was observed among younger women admitted with AMI. Regardless of gender, depression affected those with a lower socio-economic status and cardiovascular risk factors; it was also accompanied with high levels of stress and worse health status. Targeted interventions and preventive strategies should consider addressing this high burden of depressive symptoms among younger depressed AMI patients.