Overview
- Published in Circulation, the American Heart Association’s scientific statement compiles evidence and proposes considering post‑myocardial infarction depression as a formal cardiac risk factor.
- About 33% of heart attack survivors develop depression annually, while anxiety and stress affect up to 50% during hospitalization and persist in 20–30% after discharge.
- Risk estimates include 1.3 times higher odds of another heart attack or death with post‑MI anxiety, with depression and PTSD linked to roughly double the risk of recurrent events or mortality.
- A pooled review found graded long‑term risk after a mean 4.7 years, with moderate distress tied to a 28% increase in future MI and high or very high distress tied to a 60% increase versus low distress.
- Evidence‑based options include cognitive behavioral therapy, mindfulness and SSRIs shown safe in cardiovascular disease, while cardiac rehab reduces distress yet remains underused with participation below 20% and routine screening practices still unsettled.