Clinical InvestigationOutcomes, Health Policy, and Managed CareInitiation of statin therapy after acute myocardial infarction is not associated with worsening depressive symptoms: Insights from the Prospective Registry Evaluating Outcomes After Myocardial

BackgroundWhereas statins are considered the cornerstone of prevention after acute myocardial infarction (AMI), concerns about worsening depression in association with their use have been raised.MethodsUsing 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.ResultsOf 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).ConclusionsInitiation of statins after AMI was not associated with worsening depression.