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Treatment-Resistant Depression and Mortality After Acute Coronary Syndrome
Open accessAbstract
Depression is a risk factor for morbidity and mortality in patients with coronary heart disease, especially following acute coronary syndrome. Evidence from recent clinical trials suggests that treatment-resistant depression may be associated with a particularly high risk of mortality or cardiac morbidity in patients following acute coronary syndrome. This article reviews this evidence and considers possible explanations for this relationship. Directions for future research are also considered, with particular emphasis on efforts to elucidate the underlying mechanisms and to develop more efficacious treatments for depression in patients with coronary heart disease.
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“Although there are conflicting data on the cardiovascular benefits of antidepressants in patients with CVD, a synthesis of data from numerous intervention trials found that unsuccessful treatment of depression after hospitalization for ACS is linked to elevated risk of mortality and cardiac events. 183”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [183]
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Cited by
Sorted by citations
Selective publication of antidepressant trials and its influence on apparent efficacy
Turner, E. H., Matthews, A. M., Linardatos, E., Tell, R. A., & Rosenthal, R. (2008) · New England Journal of Medicine · doi:10.1056/nejmsa065779 · Cited by 2,435
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“Depression is frequently comorbid with other mental and physical difficulties, most often with anxiety disorders, but also with cardiac problems and smoking (e.g., Carney & Freedland 2009).”
BackgroundLichtman, 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., et al. (2014) · Circulation · doi:10.1161/cir.0000000000000019 · Cited by 1,208
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“…and acute-phase proteins than patients who respond to antidepressant treatment (Sluzewska et al., 1997, Lanquillon et al., 2000, Fitzgerald et al., 2006), and are at even greater risk of morbidity and mortality in medical illness such as coronary heart disease (Carney and Freedland, 2009).”
BackgroundLevine, G. N., Cohen, B. E., Commodore-Mensah, Y., Fleury, J., Huffman, J. C., Khalid, U., Labarthe, D. R., Lavretsky, H., Michos, E. D., Spatz, E. S., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000947 · Cited by 865
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“sodes that do not respond to standard treatments have also been identified as high-risk subtypes.(35) However, evidence suggests that recognition and treatment of depression improves prognosis.”
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Meta-review of depressive subtyping models
Harald, B., & Gordon, P. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.07.015 · Cited by 328
“Secondary analyses of recent trials and longitudinal studies, however, indicate that such patients with new-onset depression are more likely to be nonresponsive to antidepressant medication and psychotherapy, and show an increased mortality risk (Carney and Freedland, 2009; Parker et al., 2008, 2011b).”
BackgroundResultIsingrini, E., Camus, V., Le Guisquet, A.-M., Pingaud, M., Devers, S., & Belzung, C. (2010) · PLoS ONE · doi:10.1371/journal.pone.0010404 · Cited by 277
“Furthermore, treatment-resistant major depression is also frequently described in patients with acute coronary heart disease, and seems to increase risk of mortality after acute coronary syndrome [7].”
BackgroundThe epidemiology of excess mortality in people with mental illness
Lawrence, D., Kisely, S., & Pais, J. (2010) · The Canadian Journal of Psychiatry · doi:10.1177/070674371005501202 · Cited by 258
“Severity or persistence of depression following admission for myocardial infarction had been associated with a doubling of mortality during subsequent years.(42,46,48,49) Timing of depression may also have an influence.”
BackgroundDepression and Cardiovascular Disorders
Whooley, M. A., & Wong, J. M. (2013) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050212-185526 · Cited by 241
“Individuals with treatment-resistant depression after ACS have been identified as a particularly high-risk subgroup in other clinical trial populations as well, including the Enhancing Recovery in Coronary Heart Disease (ENRICHD), the Myocardial Infarction and Depression Intervention Trial (MIND-IT), and the Montreal…”
BackgroundChauvet‐Gélinier, J., & Bonin, B. (2016) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2016.09.002 · Cited by 262
Anxiety and cardiovascular disease risk: a review
Tully, P. J., Harrison, N. J., Cheung, P., & Cosh, S. (2016) · Current Cardiology Reports · doi:10.1007/s11886-016-0800-3 · Cited by 211
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“This work is mostly based on re-analyses of existing epidemiological and clinical trial data, and has involved several approaches, including examining prognostic differences between various depression symptom clusters,(23) 24 comparing cardiac outcomes in patients with first depressions and those with recurrent episod…”
MethodThe Economic Burden of Treatment-Resistant Depression
Olchanski, N., McInnis Myers, M., Halseth, M., Cyr, P. L., Bockstedt, L., Goss, T. F., & Howland, R. H. (2013) · Clinical Therapeutics · doi:10.1016/j.clinthera.2012.09.001 · Cited by 146
Treatment-Resistant Depression in Primary Care across Canada
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“Further therapy directed at PS, includi ng behavior modification, psychotherapy, and/or pharmacologic intervention could be required .(66,69,70) The recent data with SMT seems particularly attractive for improving the already substantial improvements noted with CRET.”
MethodPsychopharmacology and Cardiovascular Disease
Piña, I. L., Di Palo, K. E., & Ventura, H. O. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.03.458 · Cited by 126
“However, because selective serotonin reuptake inhibitors (SSRIs) are commonly used as antidepressants in patients with CAD, who are also likely to receive antiplatelet agents, the potential interaction of a serotonin transporter inhibitor with aspirin (ASA) and/or clopidogrel is worth noting (31–33).”
BackgroundInfluentialFavaro, A., Gerosa, G., Caforio, A. L. P., Volpe, B., Rupolo, G., Zarneri, D., Boscolo, S., Pavan, C., Tenconi, E., d’Agostino, C., et al. (2010) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.10.001 · Cited by 120
“Depressive symptoms are considered to be a negative prognostic factor in patients with cardiovascular diseases [6,7].”
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Demyttenaere, K., & Van Duppen, Z. (2019) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyy052 · Cited by 98
“Although current evidence does not seem univocally conclusive on the effect of treatment intervention on morbidity and mortality (Carney and Freedland, 2009), research does show that the risk of cardiovascular morbidity and mortality is higher in patients who are non-responsive to treatment.”
BackgroundImpact of Exercise Training on Psychological Risk Factors
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Novel drug developmental strategies for treatment‐resistant depression
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“Also, TRD patients have a significantly higher rate of mortality due to external causes, that is, suicide and accidents (Döme et al., 2021; Reutfors et al., 2018), and after acute coronary syndrome (Carney & Freedland, 2009; Scherrer et al., 2012).”
BackgroundMortality in treatment-resistant unipolar depression: A register-based cohort study in Sweden
Reutfors, J., Andersson, T. M.-L., Brenner, P., Brandt, L., DiBernardo, A., Li, G., Hägg, D., Wingård, L., & Bodén, R. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.06.030 · Cited by 94
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“adverse cardiac outcomes than other subtypes, such as depression with salient somatic symptoms [9].”
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Sher, Y. I., Lolak, S., & Maldonado, J. R. (2010) · Current Psychiatry Reports · doi:10.1007/s11920-010-0116-8 · Cited by 75
Depression, Antidepressant Use and Mortality in Later Life: The Health in Men Study
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“explanation for our results [42].”
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Carney, R. M., & Freedland, K. E. (2012) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3182405ac4 · Cited by 72
“Patients with a recent acute coronary syndrome who have residual depression symptoms after treatment are at higher risk for mortality (52), so perhaps the goal of treatment should not be to target somatic symptoms per se but rather to treat each patient to complete remission.”
BackgroundSelf-citationRole of glutamate receptors and glial cells in the pathophysiology of treatment-resistant depression
Kim, Y.-K., & Na, K.-S. (2016) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2016.03.009 · Cited by 84
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Scherrer, J. F., Chrusciel, T., Garfield, L. D., Freedland, K. E., Carney, R. M., Hauptman, P. J., Bucholz, K. K., Owen, R. R., & Lustman, P. J. (2012) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.111.096479 · Cited by 68
Self-citationUnipolar Depression and the Progression of Coronary Artery Disease: Toward an Integrative Model
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Apostolopoulou, K., Kunzel, H. E., Gerum, S., Merkle, K., Schulz, S., Fischer, E., Pallauf, A., Brand, V., Bidlingmaier, M., Endres, S., et al. (2012) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2012.665480 · Cited by 73
“Again depression and phobic anxiety are risk factors in patients with cardiac diseases (Watkins et al., 2006; Brown et al. 2009; Carney and Freedland 2009; Lippi et al. 2009) Gender differences in epidemiology, in response to antidepressive treatment and HPA-axis during major depression have been…”
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“Another subtype of depression that is related to cardiac disease is treatment-resistant depression, which is particularly associated with the risk of poor cardiovascular outcomes [38,66].”
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“Non-adherence to both depression treatment and cardiac aftercare procedures may explain why cardiac patients with treatment resistant depression have the highest risk of cardiovascular morbidity and mortality [29,30].”
Szczepańska-Gieracha, J., Jóźwik, S., Cieślik, B., Mazurek, J., & Gajda, R. (2021) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2020.0297 · Cited by 64
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“30 As Eaton reviews, 31 major depression increases the risk of first heart attack (odds ratio [OR] 3.9), stroke (OR 2.7) and diabetes (OR 2.23).”
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“The majority of studies failed to show an improvement of cardiovascular outcomes after treatment of depression [35,36], which may have been caused by a substantial group of patients at increased risk for mortality who did not respond to the depression intervention [37].”
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“The timing of onset of depression relative to CHD, comorbidity of depression with other adverse psychosocial factors, symptom dimensions of depression, and the trajectory of depressive symptoms are likely to impact upon the outcome of depression as well as CHD [17–20,26,31,34,72–80].”
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“Patients with treatment-resistant depression may be at especially high risk of adverse cardiovascular outcomes, and it has been suggested that inflammation may help explain poor responsiveness to depression treatment [5].”
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“Patients who have persistent depression after the cardiac event seem to be at especially increased risk for major cardiac events and mortality (8,9).”
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Personality traits and medical outcome of cardiac illness
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“Carney (Carney and Freedland, 2009) has reviewed the literature on depression and the medical outcome of cardiac disease and concluded that refractory depression is the key type of depression which negatively influences outcome.”
BackgroundDavidson, K. W., & Korin, M. (2010) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.77.s3.04 · Cited by 29
Šagud, M., Mihaljević-Peleš, A., Uzun, S., Ćusa, B. V., Kozumplik, O., Mikulić, S. K., Mustapić, M., Barišić, I., Mück‐Šeler, D., & Pivac, N. (2013) · Psychopharmacology · doi:10.1007/s00213-013-3085-x · Cited by 34
“Although TRD appears to be a common clinical condition, remarkably little is known about the underlying biology (Carney and Freedland 2009).”
BackgroundResultCardiovascular Disease, Depression and Mortality: The Health In Men Study
Almeida, O. P., Alfonso, H. S., Flicker, L. A., Hankey, G. J., & Norman, P. E. (2011) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e318211c1ed · Cited by 26
Inflammation and Treatment-Resistant Depression from Clinical to Animal Study: A Possible Link?
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“TRD remains a common condition, accounting for approximately 30% of all patients with depression [32].”
BackgroundAdekkanattu, P. M., Olfson, M., Susser, L. C., Patra, B. G., Vekaria, V., Coombes, B. J., Lepow, L., Fennessy, B., Charney, A. W., Ryu, E., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.044 · Cited by 32
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“This precludes any inferences about the role of the course of depression and anxiety for mortality [35].”
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“The current findings should thus serve to raise awareness regarding psychiatric illness complexity and comorbidity, particularly as treatment-resistant depression increases cardiovascular risk [74,75].”
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Impact and Clinical Management of Depression in Patients with Coronary Artery Disease
Summers, K. M., Martin, K. E., & Watson, K. (2010) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1592/phco.30.3.304 · Cited by 29
“Studies have also identified those with treatment-resistant depression as a high-risk population with higher fatality rates than patients who experience remission or even a partial response to treatment.(5) Data from the Heart and Soul Study, a crosssectional survey of 1024 people with CAD, revealed that those with de…”
BackgroundDepressive symptom clusters are differentially associated with atherosclerotic disease
Bus, B. A. A., Marijnissen, R. M., Holewijn, S., Franke, B., Purandare, N. B., Graaf, J. D., den Heijer, M., Buitelaar, J. K., & Voshaar, R. C. O. (2010) · Psychological Medicine · doi:10.1017/s0033291710002151 · Cited by 26
“…is supported by previous findings showing a worse cardiac outcome in CAD patients with treatment-resistant depression only (de Jonge et al. 2006b ; Carney & Freedland, 2009b), as those somatic-affective symptoms due to atherosclerosis may not be affected by antidepressants but are related to…”
BackgroundResultRapp, M., Rieckmann, N., Lessman, D., Tang, C. Y., Paulino, R., Burg, M., & Davidson, K. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000286959 · Cited by 24
“Several biological correlates of depression and vascular disease have been proposed to explain the risk conferred by persistently elevated depressive symptoms [for review, see [”
BackgroundDenollet, J., Freedland, K., Carney, R., de Jonge, P., & Roest, A. (2013) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31829dbd36 · Cited by 23
“Of note, hopelessness and suicidal ideation have been related to an increased risk of treatment-resistant depression (36), and treatment-resistant depression has been associated with a particularly high risk of cardiac events after an acute coronary syndrome (37).”
BackgroundSelf-citationWoo, Y. S., McIntyre, R. S., Kim, J.-B., Lee, M., Kim, J., Yim, H. W., & Jun, T. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.06.018 · Cited by 29
Cardiac Risk Markers and Response to Depression Treatment in Patients With Coronary Heart Disease
Carney, R. M., Freedland, K. E., Steinmeyer, B. C., Rubin, E. H., Mann, D. L., & Rich, M. W. (2015) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000245 · Cited by 26
“Thus, improved survival in treatment responders seems to be independent of the type of depression treatment to which patients are exposed (11).”
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Giakoumatos, C. I., & Osser, D. N. (2019) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000197 · Cited by 27
Roest, A., Carney, R., Stein, P., Freedland, K., Meyer, H., Steinmeyer, B. C., de Jonge, P., & Rubin, E. (2011) · Journal of Clinical Psychiatry · doi:10.4088/jcp.10m06455 · Cited by 20
Self-citationCarney, R. M., Freedland, K. E., Steinmeyer, B. C., Rubin, E. H., & Ewald, G. A. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.06.045 · Cited by 18
“It has been shown that patients with CHD who do not respond to depression treatment are at high risk for cardiac mortality and morbidity [23].”
BackgroundSelf-citationCarney, R. M., Freedland, K. E., Steinmeyer, B. C., Rubin, E. H., Stein, P. K., & Rich, M. W. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.04.051 · Cited by 19
Self-citationDepression and cardiovascular disease: have a happy day--just smile!
Pitt, B., & Deldin, P. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq031 · Cited by 18
“Patients with treatment-resistant depression (failure to respond to a single trial of antidepressant) after an acute coronary syndrome are at even greater cardiovascular risk.(4) The use of antidepressants, such as selective serotonin uptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), does not”
BackgroundScreening for symptoms of depression and anxiety in a cardiology department.
Berge, T., Bull-Hansen, B., Solberg, E., Heyerdahl, E. U. R., Jørgensen, K., Vinge, L., Aarønæs, M., Øie, E., & Hyldmo, I. (2019) · Tidsskrift for Den Norske Laegeforening · doi:10.4045/tidsskr.18.0570 · Cited by 17
“Depresjon er ofte en tilbakevendende lidelse, med debut i ungdomsalder eller tidlig voksen alder, og bare et mindretall av pasientene opplever sin første depressive episode i forbindelse med hjertesykdommen (10).”
Advances in the Management of Treatment-Resistant Depression
Holtzheimer, P. E. (2010) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.8.4.foc488 · Cited by 25
How Does Mental Health Impact Women's Heart Health?
O'Neil, A. E., Russell, J. D., & Murphy, B. M. (2020) · Heart Lung and Circulation · doi:10.1016/j.hlc.2020.05.111 · Cited by 23
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Liu, S. S., & Ziegelstein, R. C. (2010) · Future Cardiology · doi:10.2217/fca.10.18 · Cited by 15
Changes in social capital and depressive states of middle-aged adults in Japan
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Clinical predictors of depression treatment outcomes in patients with coronary heart disease
Carney, R. M., Freedland, K. E., Steinmeyer, B. C., Rubin, E. H., & Rich, M. W. (2016) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2016.07.011 · Cited by 18
“[7] Other clinical trials have also shown a relationship between improvement in depression and improvement in survival using different treatments for depression, including CBT, exercise training, sertraline, mirtazapine, and citalopram.[43] Thus, improved survival in treatment responders does not seem to depend on the…”
BackgroundSelf-citationRoest, A. M., Carney, R. M., Freedland, K. E., Martens, E. J., Denollet, J., & de Jonge, P. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.02.008 · Cited by 44
“Depression treatments that also modify cardiac risk markers in patients with CHD might lead to better depression and medical outcomes (Carney and Freedland, 2009) For example, exercise therapy may offer considerable promise in patients with heart disease through a decrease in depressive symptoms and by simultaneously…”
InfluentialSelf-citationTherapeutic potential of new second generation antipsychotics for major depressive disorder
McElroy, S. L., Guerdjikova, A. I., Mori, N. N., & Keck, P. E. (2010) · Expert Opinion on Investigational Drugs · doi:10.1517/13543784.2010.538048 · Cited by 11
“Major depressive disorder (MDD) is a highly prevalent condition associated with impaired functioning and elevated morbidity and mortality [1-4].”
BackgroundTherapeutic Armamentarium for Treating Depression
Howland, R. H. (2010) · Postgraduate Medicine · doi:10.3810/pgm.2010.07.2176 · Cited by 14
Kuchibhatla, M. N., & Fillenbaum, G. G. (2011) · The American Journal of Geriatric Pharmacotherapy · doi:10.1016/j.amjopharm.2011.09.001 · Cited by 11
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Psychische Störungen bei somatischen Krankheiten
Kapfhammer, H. P. (2011) · Springer eBooks · doi:10.1007/978-3-642-03637-8_76 · Cited by 7
Freedland, K., Carney, R., Hayano, J., Steinmeyer, B. C., Reese, R. L., & Roest, A. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2011.12.012 · Cited by 12
“Recent findings from several clinical trials have shown that patients who do not respond to standard treatments for depression are at high risk for mortality after acute coronary syndrome [17].”
BackgroundSelf-citationHabra, M. E., Baker, B., Frasure‐Smith, N., Swenson, J. R., Koszycki, D., Butler, G. S., van Zyl, L. T., & Lespérance, F. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2010.02.010 · Cited by 15
“In particular, patients whose depression does not respond well to conventional therapies, “treatment-resistant depression”, may require additional resources to find effective treatment alternatives to relieve their symptoms, as this subgroup may be at increased risk for mortality [53].”
BackgroundZhang, X.-L., Huo, Q., Sun, W., Zhang, C., Wu, Z., Xing, B., & Li, Q. (2018) · Molecular Medicine Reports · doi:10.3892/mmr.2018.8929 · Cited by 11
“In clinical settings, it remains to be elucidated whether depression in patients with CAD is treatable and whether cardiac event-free-survival can be improved by treatment (22).”
Use of Cortical Stimulation in Neuropathic Pain, Tinnitus, Depression, and Movement Disorders
Panov, F. E., & Kopell, B. H. (2014) · Neurotherapeutics · doi:10.1007/s13311-014-0283-0 · Cited by 10
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Mental Health, Medical Illness, and Treatment with a Focus on Depression and Anxiety
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Psychiatric Aspects of Heart Disease (and Cardiac Aspects of Psychiatric Disease) in Critical Care
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Treatment Resistance in Psychiatry
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Kim, J. H., Song, Y., Jang, H. Y., Shin, J., Lee, H., Ahn, Y. M., Oh, J. M., & Kim, I. (2020) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001252 · Cited by 11
“Treatment-resistant depression has been identified as a risk factor of mortality after acute coronary syndromes or MI in previous studies.(41,42) Therefore, more frequent monitoring is required in selected patients to prevent insufficient or inadequate depression treatment.”
BackgroundCarney, R. M., & Freedland, K. E. (2017) · European Heart Journal - Quality of Care and Clinical Outcomes · doi:10.1093/ehjqcco/qcx019 · Cited by 8
“One of the most plausible explanations for this result is that the differences in depression between the intervention and control groups have been too small.(9)”
BackgroundSelf-citation
Metadata
- Authors
- Carney, R. M., & Freedland, K. E.
- Affiliations
- Washington University in St. Louis (US)
- Venue
- American Journal of Psychiatry
- Published
- 2009-04
- Volume
- 166
- Issue
- 4
- Pages
- 410-417
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3465939
- OpenAlex
- W2129412441
- Cited by
- 163
- References
- 62
- Citations by year
- 2025: 3 · 2024: 11 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 8 · 2018: 6 · 2017: 7 · 2016: 10 · 2015: 5 · 2014: 5 · 2013: 17 · 2012: 14
- FWCI
- 3.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL076808, HL-76808)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- treatment-resistant depression, acute coronary syndrome, mortality, coronary artery disease, cardiac morbidity, depression as risk factor
- MeSH terms
- Antidepressive Agents, Combined Modality Therapy, Depressive Disorder, Major, Major Depressive Disorder, Drug Resistance, Drug Therapy, Combination, Follow-Up Studies, Humans, Myocardial Infarction, Personality Inventory, Psychometrics, Citalopram, Comorbidity, Cognitive Behavioral Therapy, Survival Rate, Randomized Controlled Trials as Topic, Bupropion, Acute Coronary Syndrome, Secondary Prevention
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