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After multivariable adjustment, the proportion of patients with large infarction size was significantly higher in the major depression group (PHQ-9 ≥ 1 (OR 4.840, 95%CI 1.122-20.868, P =0.034). When the PHQ-9 was evaluated as a continuous variable, after multivariable adjustment, an increased PHQ-9 score was associated with an increased risk of large infarction size (OR 1.226, 95%CI 1.073-1.401, P =0.003). CONCLUSION In patients with STEMI undergoing PCI, depression was independently associated with a large infarction size. ©The A