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Long-term cardiac outcomes of depression screening, diagnosis and treatment in patients with acute coronary syndrome: the DEPACS study.
- Source :
- Psychological Medicine; Apr2021, Vol. 51 Issue 6, p964-974, 11p
- Publication Year :
- 2021
-
Abstract
- Background: To investigate the impacts of depression screening, diagnosis and treatment on major adverse cardiac events (MACEs) in acute coronary syndrome (ACS). Methods: Prospective cohort study including a nested 24-week randomised clinical trial for treating depression was performed with 5–12 years after the index ACS. A total of 1152 patients recently hospitalised with ACS were recruited from 2006 to 2012, and were divided by depression screening and diagnosis at baseline and 24-week treatment allocation into five groups: 651 screening negative (N), 55 screening positive but no depressive disorder (S), 149 depressive disorder randomised to escitalopram (E), 151 depressive disorder randomised to placebo (P) and 146 depressive disorder receiving medical treatment only (M). Results: Cumulative MACE incidences over a median 8.4-year follow-up period were 29.6% in N, 43.6% in S, 40.9% in E, 53.6% in P and 59.6% in M. Compared to N, screening positive was associated with higher incidence of MACE [adjusted hazards ratio 2.15 (95% confidence interval 1.63–2.83)]. No differences were found between screening positive with and without a formal depressive disorder diagnosis. Of those screening positive, E was associated with a lower incidence of MACE than P and M. M had the worst outcomes even compared to P, despite significantly milder depressive symptoms at baseline. Conclusions: Routine depression screening in patients with recent ACS and subsequent appropriate treatment of depression could improve long-term cardiac outcomes. [ABSTRACT FROM AUTHOR]
- Subjects :
- PREVENTION of mental depression
DIAGNOSIS of mental depression
CITALOPRAM
CONFIDENCE intervals
PSYCHOLOGY of cardiac patients
MEDICAL screening
ACUTE coronary syndrome
DISEASE incidence
RANDOMIZED controlled trials
COMPARATIVE studies
PLACEBOS
MENTAL depression
DESCRIPTIVE statistics
STATISTICAL sampling
COMORBIDITY
LONGITUDINAL method
COGNITIVE therapy
Subjects
Details
- Language :
- English
- ISSN :
- 00332917
- Volume :
- 51
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Psychological Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 153538008
- Full Text :
- https://doi.org/10.1017/S003329171900388X