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European Heart Journal Advance Access originally published online on December 21, 2006
European Heart Journal 2007 28(2):160-165; doi:10.1093/eurheartj/ehl440
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Psychological and clinical predictors of return to work after acute coronary syndrome

Mimi R. Bhattacharyya*, Linda Perkins-Porras, Daisy L. Whitehead and Andrew Steptoe

Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BK, UK

Received 15 June 2006; revised 17 November 2006; accepted 23 November 2006; online publish-ahead-of-print 21 December 2006.

* Corresponding author. Tel: +44 207 679 1688; fax: +44 207 916 8542. E-mail address: m.bhattacharyya{at}ucl.ac.uk

Aims Resumption of paid employment following acute coronary syndrome (ACS) is an important indicator of recovery, but has not been studied extensively in the modern era of acute patient care.

Methods and results A total of 126 patients who had worked before hospitalization for ACS were studied with measures of previous clinical history, ACS type and severity, clinical management, and sociodemographic characteristics. Depressed mood (Beck Depression Inventory) and type D personality were measured 7–10 days following admission. Among them, 101 (80.2%) had returned to work 12–13 months later. Failure to resume work was associated with cardiac factors on admission (heart failure, arrhythmia), cardiac complications during the intervening months, and depression scores during hospitalization. It was not related to age, gender, socioeconomic status, type of ACS, cardiac history, acute clinical management, or type D personality. In multivariate analysis, the likelihood of retuning to work was negatively associated with depression, independently of clinical and demographic factors [adjusted odds ratio 0.90, CI 0.82–0.99, P = 0.032].

Conclusion Depressed mood measured soon after admission is a predictor of returning to work following ACS. The management of early depressed mood might promote the resumption of economic activity and enhance the quality of life of cardiac patients.

Key Words: Acute coronary syndrome • Return to work • Depression • Type D • Myocardial infarction


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