Persistent depressive symptoms lower aspirin adherence after acute coronary syndromes
Abstract
Background Even mild depressive symptoms during hospitalization are an independent risk factor for mortality after acute coronary syndromes (ACS). The mortality risk is highest for patients whose depressive symptoms persist after ACS. Low adherence to medications that reduce the risk of subsequent cardiac events may be one of the mechanisms underlying the relationship between persistent depression and risk of ACS recurrence. We compared electronically monitored adherence to aspirin in 3 groups of patients with ACS: persistently depressed, remittent depressed, and persistently nondepressed. Methods Using an electronic device stored in the cap of a pill bottle, we monitored aspirin adherence over a 3-month period in 165 consecutive patients recruited within 1 week of an ACS event. Depressive symptom severity was assessed by using the Beck Depression Inventory at baseline and at 3 months. Adherence was determined by the percentage of days aspirin was taken as prescribed. Results Among the patients, 10.5% of nondepressed patients, 9.8% of remittent depressed patients, and 42.1% of persistently depressed patients took aspirin Conclusions Poor medication adherence--a potentially modifiable behavior--may contribute to the high mortality risk observed in patients with persistent symptoms of depression after ACS.
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Numerous studies have found a relationship between major depressive disorder and poor adherence to cardiovascular medications.
“Numerous studies have found a relationship between major depressive disorder and poor adherence to cardiovascular medications. 151-155”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [154]
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- Authors
- Rieckmann, N., Kronish, I. M., Haas, D., Gerin, W., Chaplin, W. F., Burg, M. M., Vorchheimer, D., & Davidson, K. W.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Columbia University (US)
- St. John's University (US)
- Corresponding author
- Davidson, Karina W.
- ORCID
- Venue
- American Heart Journal
- Publisher
- Elsevier BV
- Published
- 2006-11
- Volume
- 152
- Issue
- 5
- Pages
- 922-927
- ISSN
- 0002-8703 (ISSN-L)
- OpenAlex
- W2151543835
- Cited by
- 111
- References
- 3
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 5 · 2019: 2 · 2018: 1 · 2017: 10 · 2016: 8 · 2015: 8 · 2014: 4 · 2013: 10 · 2012: 12
- FWCI
- 5.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc25197-0-0-0)
- National Heart, Lung, and Blood Institute (HC25197, R24HL076857, K23HL004458, HL04458, HL-076857)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Keywords
- persistent depressive symptoms, aspirin adherence, acute coronary syndrome, medication adherence, depression, mortality risk, cardiac events
- MeSH terms
- Aged, Angina, Unstable, Aspirin, Depression, Female, Humans, Male, Middle Aged, Myocardial Infarction, Patient Compliance, Platelet Aggregation Inhibitors
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