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Depression and cardiovascular disease: does antidepressant treatment improve cardiac outcome?

Published online by Cambridge University Press:  13 June 2014

Damien Gallagher
Damien Gallagher*
Affiliation:
St John of God Hospital, Stillorgan, Co. Dublin.
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Abstract

Objective: The association between depression and cardiovascular disease has been well documented but the nature of this relationship continues to be defined. Given the accumulation of epidemiological evidence linking these diseases a number of interventional studies have been undertaken to assess the issue of whether antidepressant treatment in depressed patients with cardiovascular disease improves cardiac outcome. The objective of this paper is to review recent randomised controlled trials on this topic and to explore the implications that these may have for future research in this area.

Method: This review is derived from a MEDLINE search using the search terms ‘depressive disorder’ and ‘cardiovascular diseases’. Only randomised controlled trials published in English with clearly defined methods and interventions are included here. Reference sections from the articles were used to identify additional relevant studies.

Results: A small number of high quality trials were uncovered which indicated mixed results in terms of the treatment of depression in cardiovascular disease. None indicated a statistically significant difference in cardiac outcome.

Conclusions: It is not possible at this time to recommend treatment for depression to reduce cardiovascular risk. However depression remains prevalent in patients with cardiovascular disease and is a treatable cause of morbidity in its own right.

Keywords

Depressive disorderCardiovascular diseaseAntidepressantCardiac outcomeIschaemic heart disease.
Type
Reviews
Information
Irish Journal of Psychological Medicine , Volume 24 , Issue 4 , December 2007 , pp. 156 - 158
Copyright
Copyright © Cambridge University Press 2007

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References

1.Murray, CJL, Lopez, AD. Global mortality, disability, and the contribution of risk factors: global burdens of disease study. Lancet 1997; 349: 1436–1442.CrossRefGoogle ScholarPubMed
2.Hayward, C. Psychiatric illness and cardiovascular disease risk. Epidemiol Rev 1995; 17: 129–138.CrossRefGoogle ScholarPubMed
3.Ford, DE, Mead, LA, Chang, PP, Levine, DM, Klag, MJ. Depression predicts cardiovascular disease in men: the precursors study. Circulation 1994; 90: 614.Google Scholar
4.Everson, SAet al.Hopelessness and risk of mortality and incidence of myocardial infarction and cancer. Psychosom Med 1996; 58: 113–121.CrossRefGoogle ScholarPubMed
5.Pratt, LA, Ford, LE, Crum, RM, Armenian, HK, Gallo, JJ, Eaton, WW. Depression, psychotropic medication and risk of myocardial infarction: prospective data from the Baltimore ECA follow up. Circulation 1996; 94: 3123–3129.CrossRefGoogle ScholarPubMed
6.Penninx, BWet al.Depression and cardiac mortality: results from a community based longitudinal study. Arch Gen Psychiatry 2001; 58: 221–227.CrossRefGoogle ScholarPubMed
7.Frasure-Smith, N, Lesperance, F, Talajic, M. Depression following myocardial infarction: impact on 6-month survival. JAMA 1993; 270: 1819–1861.CrossRefGoogle ScholarPubMed
8.Frasure-Smith, N, Lesperance, F, Talajic, M. Depression and 18-month prognosis after myocardial infarction. Circulation 1995; 91: 999–1005.CrossRefGoogle ScholarPubMed
9.Blumenthal, JAet al.Depression as a risk factor for mortality after coronary artery bypass surgery. Lancet 2003; 362: 604–609.CrossRefGoogle ScholarPubMed
10.Carney, RM, Freedland, KE, Sheline, YL, Weiss, ES. Depression and coronary heart disease: a review for cardiologists. Clin Cardiol 1997; 20: 196–200.CrossRefGoogle ScholarPubMed
11.Alexopoulos, GS, Meyers, BS, Young, RC, Campbell, S, Sibersweig, D, Charlson, M. ‘Vascular depression’ hypothesis. Arch Gen Psychiatry 1997; 54: 915–922.CrossRefGoogle ScholarPubMed
12.Nemeroff, CBet al.Elevated concentrations of CSF corticotropin-releasing factorlike immunoreactivity in depressed patients. Science 1984; 226: 1342–1344.CrossRefGoogle ScholarPubMed
13.Risch, SCet al.Limbic-hypothalamic-pituitary-adrenal renal axis activityand ventricular to brain ratio studies in affective illness and schizophrenia. Neuropsychopharmacol 1992; 6: 95–100.Google Scholar
14.Raadsheer, FC, Hoogendijk, WJG, Stam, FC, Tilders, FJH, Swaab, DF. Increased numbers of corticotropin- releasing hormone expressing neurons in the hypothalamic paraventricular nucleus of depressed patients. Neuroendocrinol 1994; 60: 436–444.CrossRefGoogle ScholarPubMed
15.Rosmond, R, Bjorntorp, P. The Hypothalamic-pituitary-adrenal axis activity as a predictor of cardiovascular disease, type 2 diabetes and stroke. J Intern Med 2000; 247: 188–97.CrossRefGoogle ScholarPubMed
16.Glassman, AH. Where there is depression, There is Inflammation…Sometimes. Biol Psychiatry 2007; 62: 280–281.CrossRefGoogle Scholar
17.Libby, et al.Inflammation and Atheroscleosis. Circulation 2002; 105: 1135–1143.CrossRefGoogle Scholar
18.Miller, GE, Rohleder, N, Stetler, C, Kirschbaum, C. Clinical depression and regulation of the inflammatory response during acute stress. Psychosom Med 67: 679–687.CrossRefGoogle Scholar
19.Danese, et al.Childhood maltreatment predicts adult inflammation in a life-course study. Proc Natl Acad Sci 2007; 104: 1319–1324.CrossRefGoogle Scholar
20.Laghrissi-Thode, F, Wagner, WR, Pollock, BG, Johnson, PC, Finkel, MS. Elevated platelet factor 4 and beta-thromboglobulin plasma levels in depressed patients with ischaemic heart disease. Biol Psychiatry 1997; 42: 290–5.CrossRefGoogle Scholar
21.Carney, RM, Saunders, RD, Freedland, KE, Stein, P, Rich, MW, Jaffe, AS. Association of depression with reduced heart rate variability in coronary artery disease. Am J Cardiol 1995; 76: 562–4.CrossRefGoogle ScholarPubMed
22.Glassman, AHet al.Sertraline AntiDepressant Heart Attack Randomized Trial. JAMA 2002; 288: 701–9.CrossRefGoogle Scholar
23.Serebruany, VIet al.Platelet/endothelial biomarkers in depressed patients treated with the selective serotonin reuptake inhibitor sertraline after acute coronary events; the Sertraline AntiDepressant Heart Attack Randomised Trial (SADHART) Platelet Substudy. Circulation 2003; 108: 939–44.CrossRefGoogle ScholarPubMed
24.O'Brien, SM, Scott, LV, Dinan, TG. Antidepressant therapy and C-reactive protein levels. Br J Psychiatry 2006; 188: 449–452.CrossRefGoogle ScholarPubMed
25.Writing Committee for the ENRICHD Investigators. The Effects of Treating Depression and Low Perceived Social Support on clinical Events after myocardial Infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA 2003; 289: 3106–16.CrossRefGoogle Scholar
26.Van Melle, JPet al.MIND-IT investigators. Effects of antidepressant treatment following myocardial infarction. Br J Psychiatry 2007; 190: 460–6.CrossRefGoogle ScholarPubMed
27.Carney, RM, Freedland, KE. Does treating depression improve survival after acute coronary syndrome? Br J Psychiatry 2007; 190: 467–8.CrossRefGoogle ScholarPubMed
28.Lesperance, et al.Effects of Citalopram and Interpersonal Psychotherapy on Depression in Patients with Coronary Artery Disease (CREATE Trial). JAMA 2007; 297: 367–379.CrossRefGoogle ScholarPubMed