Key result
Depression affects 25-30% of patients with ischemic heart disease and acts as an independent risk factor for poor prognosis, though studies lack power to assess cardiovascular outcome improvements.
Why the study?
Do interventions for depression improve cardiovascular outcomes in patients with ischemic heart disease?
Do interventions for depression improve cardiovascular outcomes in patients with ischemic heart disease?
Depression is a highly prevalent independent risk factor in ischemic heart disease, and while certain antidepressants are safe and effective for depression symptoms, their impact on cardiovascular outcomes remains inadequately studied.
Depression screening merits consideration in ischemic heart disease; leaves open whether interventions improve cardiovascular outcomes.
PURPOSE OF REVIEW: Discuss the interplay of depression and ischemic heart disease. Studies demonstrate high prevalence of depression and its negative impact among patients with ischemic heart disease. RECENT FINDINGS: Results extend previous findings among men, demonstrating a significant increase in mortality and cardiovascular events among depressed women. Sertraline, citalopram and mitrazapine have been shown to be safe and well tolerated in patients with ischemic heart disease. Sertraline and citalopram have demonstrated efficacy for treating depression in such patients. Mirtazapine did not have significant efficacy on post-myocardial infarction depression. Cognitive-behavioral therapy and interpersonal therapy have not been found to have a significant treatment effect. Treating depression may have an impact on cardiovascular morbidity and mortality, but this has not yet been adequately studied. Studies to date lack sufficient statistical power to fully examine the impact of interventions for depression on cardiovascular outcomes. SUMMARY: Cardiologists encounter depression among 25-30% of their patients with ischemic heart disease. Depression is an independent risk factor for poor prognosis among ischemic heart disease patients, at a level comparable to several conventional cardiac risk factors. Adequate treatment of depression may improve the poor prognosis of depressed patients with ischemic heart disease.
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Rivelli et al. (2007) conducted a review in Ischemic heart disease and depression. Depression treatments (sertraline, citalopram, mirtazapine, CBT, IPT) was evaluated. Depression affects 25-30% of patients with ischemic heart disease and acts as an independent risk factor for poor prognosis, though studies lack power to assess cardiovascular outcome improvements.
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