Cited by 1,208Cardiac Health and Mental HealthAcute Myocardial Infarction ResearchCardiac Imaging and Diagnostics

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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

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Lichtman, Judith H., Froelicher, Erika S., Blumenthal, James A., Carney, Robert M., Doering, Lynn V., Frasure-Smith, Nancy, Freedland, Kenneth E., Jaffe, Allan S., Leifheit-Limson, Erica C., Sheps, David S., Vaccarino, Viola, Wulsin, Lawson·2014·Circulation

DOI 10.1161/cir.0000000000000019

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Abstract

Background—: Although prospective studies, systematic reviews, and meta-analyses have documented an association between depression and increased morbidity and mortality in a variety of cardiac populations, depression has not yet achieved formal recognition as a risk factor for poor prognosis in patients with acute coronary syndrome by the American Heart Association and other health organizations. The purpose of this scientific statement is to review available evidence and recommend whether depression should be elevated to the status of a risk factor for patients with acute coronary syndrome. Methods and Results—: Writing group members were approved by the American Heart Association’s Scientific Statement and Manuscript Oversight Committees. A systematic literature review on depression and adverse medical outcomes after acute coronary syndrome was conducted that included all-cause mortality, cardiac mortality, and composite outcomes for mortality and nonfatal events. The review assessed the strength, consistency, independence, and generalizability of the published studies. A total of 53 individual studies (32 reported on associations with all-cause mortality, 12 on cardiac mortality, and 22 on composite outcomes) and 4 meta-analyses met inclusion criteria. There was heterogeneity across studies in terms of the demographic composition of study samples, definition and measurement of depression, length of follow-up, and covariates included in the multivariable models. Despite limitations in some individual studies, our review identified generally consistent associations between depression and adverse outcomes. Conclusions—: Despite the heterogeneity of published studies included in this review, the preponderance of evidence supports the recommendation that the American Heart Association should elevate depression to the status of a risk factor for adverse medical outcomes in patients with acute coronary syndrome.

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“The American Heart Association and the European Society of Cardiology suggest that treatment of depression may be key to improving the prognosis of coronary heart disease (Lichtman et al., 2014; Vaccarino et al., 2020).”
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Association between anxiety and clinical outcomes in Chinese patients with myocardial infarction in the absence of obstructive coronary artery disease
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Patients with depression are less likely to go home after critical limb revascularization
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Off-Target Effects of Antidepressants on Vascular Function and Structure
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“While conditions such as post-traumatic stress disorder are being increasingly recognized as risk factors for CVD [ 158], the link between depression and its impact on heart disease is already well established [159].”
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Risk factors in iatrogenic spinal cord injury
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Background
Associations of NT-proBNP and parameters of mental health in depressed coronary artery disease patients
Fangauf, S. V., Belnap, B. H., Meyer, T., Albus, C., Binder, L., Deter, H., Ladwig, K., Michal, M., Ronel, J., Rothenberger, A., et al. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.06.001 · Cited by 20
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Prioritization, Development, and Validation of American Association of Cardiovascular and Pulmonary Rehabilitation Performance Measures
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Authors: Lichtman, J. H., Froelicher, E. S., Blumenthal, J. A., Carney, R. M., Doering, L. V., Frasure-Smith, N., Freedland, K. E., Jaffe, A. S., Leifheit-Limson, E. C., Sheps, D. S., Vaccarino, V., & Wulsin, L.
ORCID: Lichtman, Judith H.
Froelicher, Erika S.
Blumenthal, James A.
Carney, Robert M.
Freedland, Kenneth E.
Jaffe, Allan S.
Vaccarino, Viola
Wulsin, Lawson
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-03-25
Volume: 129
Issue: 12
Pages: 1350-1369
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/cir.0000000000000019
OpenAlex: W2137977071
Cited by: 1,208
References: 129
Citations by year: 2026: 65 · 2025: 87 · 2024: 95 · 2023: 106 · 2022: 107 · 2021: 100 · 2020: 108 · 2019: 105 · 2018: 112 · 2017: 90 · 2016: 113 · 2015: 86 · 2014: 32
FWCI: 17.24
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: American Heart Association
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Keywords: depression, acute coronary syndrome, cardiovascular risk factors, prognosis, all-cause mortality, cardiac mortality
MeSH terms: American Heart Association, Cardiology, Depression, Humans, Prognosis, Risk Factors, United States, Practice Guidelines as Topic, Evidence-Based Medicine, Acute Coronary Syndrome

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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

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