Study / Objective / Design/
Sample / Subjects / Procedure / Findings
Carney et al. (1988) / Examine MDD major cardiac endpoints associations in CAD pts / Prospective/ Clinical / 52 CAD patients / Patients assessed with modified version of DIS for major Sx of depression. Patients followed up 12-13 months later. / More MDD patients (77.7%) had at least one major cardiac event compared to non-MDD (34.9%). MDD significantly predicted occurrence of cardiac events in the first 12 months following diagnostic coronary angiography, and was best single predictor
Frasure-Smith et al. (1993) / Examine association between MD MI and prognostic implications. / Prospective/ Clinical / 222 patients with MI / The NIHM DIS assessed for MDD during hospitalisation. Survival status determined at 6-mth follow-up / Depression significantly predicted cardiac mortality (HR 5.74) and remained after controlling for factors (adjusted HR 4.29). MD was an independent risk factor for mortality at 6 months
Frasure-Smith et al. (1995) / Examine association between MD MI. / Prospective/ Clinical / 222 patients with MI / Patients interviewed with NIHM DIS and BDI during hospitalisation. Survival status determined at 18-mth follow-up / DIS (OR 3.64) and BDI scores ≥ 10 (OR 7.82) significantly associated with 18-month cardiac mortality. Mortality rate higher among depressed patients with PVCs ≥10/ hour (OR 29.1)
Barefoot et al. (1996) / Examine relationship between depression, mortality risk CAD / Prospective/ Clinical / 1250 CAD patients / Zung SDS assessed for depression. Patients followed up 6 and 12 months after hospitalisation and annually thereafter for up to 19.4 yrs / Zung SDS scores predicted cardiac death during follow-up after controlling for factors
Death rates:
Mod-Sever depressed: 51.4%; Mild depressed: 42.4%; No depression: 35.5%
Wassertheil-Smoller et al. (1996) / Determine relationship between depressive Sx CV events or mortality / Prospective/ Clinical / 4367older adults with isolated systolic HT / Short-Care Depressive Symptoms Scale and CES-D assessed for depressive Sx. Avg follow-up 4.5 yrs / Subsequent stroke, MI, or death from any cause over the following 5 years was not predicted by baseline depression scores; similar prevalence among scores < 16 and ≥ 16. 25% increased risk of death/5-unit ↑in CES-D scores
Everson et al. (1998) / Examine association between depressive Sx and stroke mortality / Prospective/ Community / 6626 participants / Depressive Sx assessed with the HPL-DS. Score ≥ 5 = depression or mood disturbance. Follow-up period 29 years / 14.5 % with HPL-DS score ≥5 at baseline (HR = 1.66 after adjustments). 1-point ↑on the HPL-DS associated with 8% ↑in risk of stroke mortality. 8.8% non-depressed patients and 17.9% depressed patients had HT
Ariyo et al. (2000). / Determine if depressive Sx are a risk factor for CHD total mortality / Prospective cohort/ Community / 4493 elderly participants. / CES-D assessed depressive Sx. Follow-up period 6 years / Higher CES-D baseline scores associated with significantly higher mortality risk but not CHD risk. Baseline depression significantly predicted CHD and mortality after adjustment for factors
Lesperance et al (2000) / Examine impact of depression on 1-year cardiac prognosis following episode of unstable angina. / Prospective/ Clinical / 430 patients with unstable angina / DIS and BDI assessed depressive symptoms / Depressed patients (BDI score ≥ 10) significantly more likely to die of cardiac causes or experience nonfatal MI than non-depressed patients (OR 4.68)
Abramson et al (2001) / Examine if depression predicts heart failure / Prospective/ Clinical / 4538 older adults with isolated systolic HT / CES-D assessed depressive Sx. Avg follow-up 4.5 years / During follow-up, 3.2% non-depressed persons experienced heart failure, compared to 8.1% of depressed persons after controlling for factors (HR 2.59) and MI in the follow-up period (HR 2.82)
Williams et al (2002) / Examine impact of depression on HF incidence / Prospective/ Community / 2812 participants / Depressive Sx measured with CES-D / Depressives significantly more likely to have HT. CES-D score ≥ 21 a significant risk factor for HF (HR 1.69). Incidence of HF among depressives relative to non-depressives marginally significant (adjusted HR 1.52). Depression significantly associated with an ↑risk of HF in women (HR 1.96) but not in men (HR 0.62)
Lauzon et al (2003) / Examine prevalence of depressive Sx prognostic impact after AMI / Prospective/ Clinical / 550AMI patients / BDI assessed baseline depressive Sx. Patients completed BDI follow-up at 30 days, 6 mths, and 1 year / At baseline, 35% reported depressive Sx. Prevalence ↑at 30 days (39%) & 6 months (39%), but ↓by 1 year (30%). 70% depressed patients at baseline were depressed at 30 days. 24% of non-depressed patients at baseline were depressed at 30 days
Everson-Rose et al (2004) / Examine association between depressive Sx mortality / Prospective/ Community / 3617 non-institutionalised adults / CES-D measured depressive Sx / The risk for mortality over 7.5 year follow up ↑by 21% per 1-standard unit increase in CES-D score (adjusted HR 1.21). No significant association between depressive Sx and CV mortality
Williams et al (2004) / Examine effect of post-stroke depression on mortality after ischemic stroke / Retrospective/ Clinical / 51,119 patients hospitalised after ischemic stroke / Data collected from medical centre databases / 5% diagnosed with depression 3 yrs after stroke. Depression independently ↑mortality risk after stroke (adjusted HR 1.13).
With depression Vs Without:
HT: 65.1%, 60.9%; CAD: 26.2%, 20.0%; MI: 8.9%, 2.3%; CHF: 8.9%, 8.4%
Gump et al (2005) / Examine association between mortality risk depressive Sx / Prospective/ / 12886 men with above avg risk of CHD but without diagnosis. / CES-D assessed depressive Sx. Median follow-up 18 yrs / Those with more depressive Sx significantly more likely to experience a non-fatal CVD event compared to those who reported fewer Sx. More depressive Sx associated with significantly ↑post-trial risk for CVD (adjusted HR 1.05) and stroke (adjusted HR 1.20) mortality
Wulsin et al. (2005) / Examine association between depressive Sx and incident coronary disease all-cause mortality / Prospective/ Community / 3634 subjects / Depressive Sx measured with CES-D. Avg follow-up 5.9yrs / Depressive Sx did not predict hard coronary disease events (MI or coronary death)
Rutledge et al. (2006) / Assess relationship between depression and atherosclerosis RF and major clinical events / Prospective/ Clinical / 505 women referred for coronary angiography / BDI assessed baseline depressive Sx. Avg follow-up period 4.9 years - occurred at 6 weeks and then yearly thereafter / Subjects with combined high BDI scores and treatment history had ↑ mortality risk compared to non-depressives (RR, 2.9; adjusted RR, 2.5)
Ahto et al (2007) / Examine association between depression and CHD or MI mortality risk / Prospective/ Community / 1196 elderly adults / Depression Sx assessed with Zung SRS. Avg follow-up period 12 yrs / Participants with more depressive Sx had significantly higher CHD mortality than non-depressives. Stronger depressive Sx significantly associated with ↑ CHD or MI mortality
Surtees et al. (2008) / Examine association between MDD, and IHD mortality. / Prospective/ Community / 19649 participants / Subjects assessed for depression with HLEQ. Median follow-up median 8.5yrs / Subjects who reported MDD in year prior to baseline were at 2.7 greater IHD mortality risk during follow-up relative to non- MDD subjects independent of traditional RF
Whooley et al (2008) / Determine why depressive Sx are associated with increased risk for CVD events / Prospective/ Clinical / 1017 outpatients with stable CHD / PHQ and Computerised DIS assessed depression. Avg follow-up 4.8 yrs / Persons with depressive Sx were significantly more likely to have CV event (10%) than those without (6.7%) (HR 1.50). After adjustment for factors including physical inactivity, the association was no longer significant
Kendler et al. (2009) / To assess a casual relationship between MD and CAD / Prospective/ Community / 15,284 Swedish twin pairs / MD assessed with CIDI-short form. CAD assessed with hospital discharge records and death certificates / Prediction of MD after onset of CAD:
concurrent MD - HR 2.83 (all), 3.56 (men), HR 3.43 (women)
subsequent MD - HR 1.75 (all), 1.96 (men), HR 1.77 (women)
Prediction of CAD after onset of MD:
Concurrent CAD - HR 2.53 (all), HR 3.16 (men), HR 2.11 (women)
Subsequent MD - HR 1.17 (all), HR 1.15 (men), HR 1.17 (women)
Genetic risk for CAD predicts CAD in all (3.06), men (3.32), & women (2.78)
Abbreviations: MD Major depression; MDD Major depressive disorder; Dt Dysthymia; md Minor depression; Sx Symptoms; RF Risk factor; CHD Coronary Heart Disease; MI Myocardial infarction; HT Hypertension; CVD cardiovascular disease; CAD Coronary artery disease; DIS Diagnostic Interview Schedule; CIDI Composite International Diagnostic Interview; BDI Beck Depression Inventory; CES-D Centre for Epidemiologic Studies Depression Scale; Zung SRS Self-rating Depression Scale; HLEQ Health and Life Experiences Questionnaire; PHQ Patient Health Questionnaire; HPL-DS Human Population Laboratory Depression Scale; MHI Mental Health Inventory; OR Odds Ratio; RR Risk Ratio; HR Hazard ratio