Antidepressants and/or psychotherapy provided a small effect on depression outcomes but did not significantly influence coronary artery disease outcomes in patients with comorbid depression.
Systematic Review
Do treatment interventions for depression (psychotherapy and/or medications) improve CAD outcomes and depression outcomes in adults with CAD and comorbid depression?
Psychological and pharmacological interventions for depression in CAD patients provide only a small effect on depression outcomes and do not significantly influence CAD outcomes.
Depression is an independent risk factor for coronary artery disease (CAD). Both illnesses contribute significantly to the global burden of disease. This systematic literature review examines treatment interventions for CAD patients with comorbid depression. We systematically reviewed The Cochrane Library, MEDLINE, EMBASE, PsycINFO, PUBMED, CINAHL and the ISRCTN Registry for English language randomised control trials investigating treatment interventions for depression in adults with CAD and comorbid depression. Data extracted included author name(s), year published, number of participants, enrolment criteria, depression definition/measures (standardised interviews, rating scales), description of control arms and interventions (psychotherapy and/or medications), randomisation, blinding, follow-up duration, follow-up loss, depression scores and medical outcome. The database search revealed 4464 articles. The review yielded 19 trials. Antidepressant and/or psychotherapy did not significantly influence CAD outcomes in the overall population. There was no difference between antidepressant use and aerobic exercises. Psychological interventions and pharmacological interventions provide small effect on depression outcomes in CAD patients. Patient autonomy in choice of treatment is associated with greater depression treatment satisfaction, but the majority of studies are underpowered. More research is required to explore the role of neurostimulation treatment, complementary and alternative treatments.
Akóṣílè et al. (Tue,) conducted a systematic review in Coronary artery disease and comorbid depression. Antidepressants and/or psychotherapy vs. Control was evaluated on CAD outcomes and depression outcomes. Antidepressants and/or psychotherapy provided a small effect on depression outcomes but did not significantly influence coronary artery disease outcomes in patients with comorbid depression.