A few things come to mind about what might be done from here. 1. Your EF at six weeks after a heart attack is 40-45% which is somewhat reduced but far from the edge of disaster. I know patients living near-normal lives on 15% EF. I also know that with a good regimen of medication we often see the EF creep back to normal at six months to a year out. 2. Since you are obviously are still having significant blockages, not enough has been done in regard to managing your cholesterol numbers. For someone who is having such difficulty it is worthwhile getting some very specialized advice from a cholestrol specialist (often affliated with major research university hospitals). He/she can run specialized tests and then adjust medications based on the results. Even if your numbers seem to be in line, the standard cholestrol lab tests given are just measuring markers for other things - the better test will actually measure the specific components that contribute to heart disease. Also some good studies show us that beating LDL below 50, even to 25 continued show benefit...recently there was even reversal of plaques demonstrated. 3. Congratulations on seeking help regarding your depression. Interestingly depression is an independent risk factor for patients to do poorly after having had a heart attack. It is therefore very important that you get your depression well treated - and do not dismiss the idea of medication if necessary. If you are not sleeping well, be sure to get that treated too. No one can start to get back into the normal swing in a sleep deprived state. 4. If you are not working with a cardiac rehab unit you very much ought to be...both from cardiac and from mental health perspective. You have some things on your plate, but they are not unmanagable. There is no reason to believe that you have one foot in the grave. Consider the things above and I am confident that you will have an improved course concerning your health. God bless and good luck.