Depression as a Risk Factor for Poor Prognosis Among Patients With Acute Coronary Syndrome: Systematic Review and Recommendations
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- 25 March 2014
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 129 (12), 1350-1369
- https://doi.org/10.1161/cir.0000000000000019
Abstract
Background—: Although prospective studies, systematic reviews, and meta-analyses have documented an association between depression and increased morbidity and mortality in a variety of cardiac populations, depression has not yet achieved formal recognition as a risk factor for poor prognosis in patients with acute coronary syndrome by the American Heart Association and other health organizations. The purpose of this scientific statement is to review available evidence and recommend whether depression should be elevated to the status of a risk factor for patients with acute coronary syndrome. Methods and Results—: Writing group members were approved by the American Heart Association’s Scientific Statement and Manuscript Oversight Committees. A systematic literature review on depression and adverse medical outcomes after acute coronary syndrome was conducted that included all-cause mortality, cardiac mortality, and composite outcomes for mortality and nonfatal events. The review assessed the strength, consistency, independence, and generalizability of the published studies. A total of 53 individual studies (32 reported on associations with all-cause mortality, 12 on cardiac mortality, and 22 on composite outcomes) and 4 meta-analyses met inclusion criteria. There was heterogeneity across studies in terms of the demographic composition of study samples, definition and measurement of depression, length of follow-up, and covariates included in the multivariable models. Despite limitations in some individual studies, our review identified generally consistent associations between depression and adverse outcomes. Conclusions—: Despite the heterogeneity of published studies included in this review, the preponderance of evidence supports the recommendation that the American Heart Association should elevate depression to the status of a risk factor for adverse medical outcomes in patients with acute coronary syndrome.Keywords
This publication has 120 references indexed in Scilit:
- Is There a High-Risk Subtype of Depression in Patients with Coronary Heart Disease?Current Psychiatry Reports, 2011
- Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis of 25 years of researchGeneral Hospital Psychiatry, 2011
- Depressive Symptoms and All-Cause Mortality in Unstable Angina Pectoris (from the Coronary Psychosocial Evaluation Studies [COPES])The American Journal of Cardiology, 2010
- Association of Anhedonia With Recurrent Major Adverse Cardiac Events and Mortality 1 Year After Acute Coronary SyndromeArchives of General Psychiatry, 2010
- Major Depression and Coronary Flow Reserve Detected by Positron Emission TomographyJAMA Internal Medicine, 2009
- Major Depression and Coronary Artery Disease in the Swedish Twin RegistryArchives of General Psychiatry, 2009
- Depressive Symptoms, Health Behaviors, and Risk of Cardiovascular Events in Patients With Coronary Heart DiseasePublished by American Medical Association (AMA) ,2008
- Genetic predictors of depressive symptoms in cardiac patientsAmerican Journal Of Medical Genetics Part B-Neuropsychiatric Genetics, 2008
- Effect of Depression on Late (8 years) Mortality After Myocardial InfarctionThe American Journal of Cardiology, 2008
- Low Heart Rate Variability and the Effect of Depression on Post–Myocardial Infarction MortalityArchives of Internal Medicine, 2005