Depression is a robust predictor of adverse outcomes in coronary heart disease, but methodological challenges make it difficult to determine if it is a causal risk factor or if treatment improves survival.
Does treatment of depression reduce mortality and cardiac morbidity in patients with coronary heart disease?
While depression is firmly established as an independent predictor of mortality and cardiac morbidity in CHD, methodological challenges and limited treatment efficacy currently prevent definitive proof of causality or that depression treatment improves cardiac event-free survival.
BACKGROUND: Depression is firmly established as an independent predictor of mortality and cardiac morbidity in patients with coronary heart disease (CHD). However, it has been difficult to determine whether it is a causal risk factor, and whether treatment of depression can improve cardiac outcomes. In addition, research on biobehavioral mechanisms has not yet produced a definitive causal model of the relationship between depression and cardiac outcomes. DISCUSSION: Key challenges in this line of research concern the measurement of depression, the definition and relevance of certain subtypes of depression, the temporal relationship between depression and CHD, underlying biobehavioral mechanisms, and depression treatment efficacy. SUMMARY: This article examines some of the methodological challenges that will have to be overcome in order to determine whether depression should be regarded as a key target of secondary prevention in CHD.
Freedland et al. (Wed,) conducted a review in Coronary heart disease and depression. Depression is a robust predictor of adverse outcomes in coronary heart disease, but methodological challenges make it difficult to determine if it is a causal risk factor or if treatment improves survival.
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