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To the Editor: In their study of the association of mental disorders with use of cardiovascular procedures after myocardial infarction, Dr Druss and colleagues¹ conclude that elderly patients (aged 65 years and older) with mental illness are less likely to undergo coronary artery catheterization or revascularization than those without mental illness. We conducted a study to determine whether these findings can be generalized to patients of all ages.

We used information from the Healthcare Investment Analysts(HCIA)-Sachs 1998 projected inpatient database,² an all-payer database that contains data from more than 40% of US inpatient discharges. Our cohort included 354,195 patients with a principal diagnosis of acute myocardial infarction, of whom 143,421 (40.5%) were younger than 65 years. Using definitions similar to those used by Druss et al, we identified 25,237 patients (7.1%) with mental illness.

Using methods similar to Druss et al, we modeled the likelihood of undergoing cardiac catheterization, percutaneous . . . [Full Text of this Article]

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