2023/05/05 by rasekh, Fatemeh, Deravi, Niloofar
#Medicine and Health Sciences
paper · doi:10.17605/osf.io/bjqku
The presence of depression in otherwise healthy individuals confers about a 1.5 to 2.0-fold adjusted relative risk for the subsequent development of coronary artery disease and is prospectively associated with a 2- to 4-fold higher relative risk for cardiac mortality and non-fatal acute myocardial infarction . In patients with established coronary heart disease (CHD), depression is associated with a 2 to 4-fold increased risk for adverse cardiac events, including fatal and non-fatal myocardial infarction (MI) and all-cause mortality In a comprehensive review of the extant literature, the American Heart Association Scientific Advisory Panel recently recommended that depression be considered a risk factor for patients with CHD. Despite the clinical relevance of depression in healthy adults and in patients with established CHD, the value of treating depression in cardiac patients has produced mixed results. The ENRICHD trial reported modest improvements in depressive symptoms relative to usual care controls in a sample of over 2500 post-myocardial infarction patients, but there was no survival benefit. The SADHART trial found that CHD patients with MDD randomized to sertraline had greater reductions in depressive symptoms compared to placebo controls, but only in a subgroup of patients with more severe MDD. However, in a study of depressed heart failure patients, sertraline did not perform any better than placebo, and there was no survival advantage for sertraline compared to placebo.