Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association.
Level 1 - systematic review of randomized trials
Systematic review of prospective prognostic cohort studies
PubMed 24566200 · doi:10.1161/CIR.0000000000000019
What was done
The American Heart Association conducted a systematic literature review to evaluate whether depression should be formally recognized as a risk factor for poor prognosis in patients with acute coronary syndrome (ACS). The review evaluated published evidence for associations with all-cause mortality, cardiac mortality, and composite outcomes (mortality and nonfatal events), assessing study strength, consistency, independence, and generalizability.
What was found
A total of 53 individual studies (32 for all-cause mortality, 12 for cardiac mortality, and 22 for composite outcomes) and 4 meta-analyses met inclusion criteria. The review identified generally consistent associations between depression and adverse post-ACS clinical outcomes. The abstract does not provide specific numerical effect sizes, hazard ratios, or risk estimates.
Why it matters
This review provides the empirical basis for the American Heart Association to formally designate depression as an established risk factor for adverse medical outcomes in patients with acute coronary syndrome.
Limits
The abstract notes substantial heterogeneity across included studies in demographic characteristics, depression definitions and measurement instruments, follow-up durations, and covariate adjustments in multivariable models. Quantitative pooled effect estimates are not reported in the abstract.
Cited by
- supports Cardiovascular disease and depression frequently co-occur as comorbidities.