BACKGROUND: Depression is associated with increased cardiac morbidity and mortality in the general population and in patients with coronary heart disease (CHD). Recent evidence suggests that patients with new-onset depression post-CHD diagnosis have worse outcomes than do those who had previous or recurrent depression. This meta-analysis investigated the timing of depression onset in established CHD and CHD-free cohorts to determine what time frame is associated with greater mortality and cardiac morbidity. METHODOLOGY/PRINCIPAL FINDINGS: The MEDLINE, EMBASE, and PsycINFO databases were searched systematically to identify articles examining a depression time frame that specified an end point of all-cause mortality, cardiac mortality, rehospitalization, or major adverse cardiac events. A meta-analysis was conducted to estimate effect sizes by time frame of depression. Twenty-two prospective cohort studies were identified. Nine studies investigated premorbid depression in CHD-free cohorts in relation to cardiac death. Thirteen studies in patient samples with CHD examined new-onset depression in comparison with previous or recurrent depression. The pooled effect size (risk ratio) was 0.76 (95% confidence interval (CI) = 0.48-1.19) for history of depression only, 1.79 (95% CI = 1.45-2.21) for premorbid depression onset, 2.11 (95% CI = 1.66-2.68) for postmorbid or new depression onset, and 1.59 (95% CI = 1.08-2.34) for recurrent depression. CONCLUSIONS/SIGNIFICANCE: Both premorbid and postmorbid depression onsets are potentially hazardous, and the question of timing may be irrelevant with respect to adverse cardiac outcomes. However, the combination of premorbid depression with the absence of depression at the time of a cardiac event (i.e., historical depression only) is not associated with such outcomes and deserves further investigation.
BACKGROUND:Depression is associated with increased cardiac morbidity and mortality in the general population and in patients with coronary heart disease (CHD). Recent evidence suggests that patients with new-onset depression post-CHD diagnosis have worse outcomes than do those who had previous or recurrent depression. This meta-analysis investigated the timing of depression onset in established CHD and CHD-free cohorts to determine what time frame is associated with greater mortality and cardiac morbidity. METHODOLOGY/PRINCIPAL FINDINGS: The MEDLINE, EMBASE, and PsycINFO databases were searched systematically to identify articles examining a depression time frame that specified an end point of all-cause mortality, cardiac mortality, rehospitalization, or major adverse cardiac events. A meta-analysis was conducted to estimate effect sizes by time frame of depression. Twenty-two prospective cohort studies were identified. Nine studies investigated premorbid depression in CHD-free cohorts in relation to cardiac death. Thirteen studies in patient samples with CHD examined new-onset depression in comparison with previous or recurrent depression. The pooled effect size (risk ratio) was 0.76 (95% confidence interval (CI) = 0.48-1.19) for history of depression only, 1.79 (95% CI = 1.45-2.21) for premorbid depression onset, 2.11 (95% CI = 1.66-2.68) for postmorbid or new depression onset, and 1.59 (95% CI = 1.08-2.34) for recurrent depression. CONCLUSIONS/SIGNIFICANCE: Both premorbid and postmorbid depression onsets are potentially hazardous, and the question of timing may be irrelevant with respect to adverse cardiac outcomes. However, the combination of premorbid depression with the absence of depression at the time of a cardiac event (i.e., historical depression only) is not associated with such outcomes and deserves further investigation.
Authors: Ileana L Piña; Carl S Apstein; Gary J Balady; Romualdo Belardinelli; Bernard R Chaitman; Brian D Duscha; Barbara J Fletcher; Jerome L Fleg; Jonathan N Myers; Martin J Sullivan Journal: Circulation Date: 2003-03-04 Impact factor: 29.690
Authors: D F Stroup; J A Berlin; S C Morton; I Olkin; G D Williamson; D Rennie; D Moher; B J Becker; T A Sipe; S B Thacker Journal: JAMA Date: 2000-04-19 Impact factor: 56.272
Authors: Gregg C Fonarow; Nancy M Albert; Anne B Curtis; Wendy Gattis Stough; Mihai Gheorghiade; J Thomas Heywood; Mark L McBride; Patches Johnson Inge; Mandeep R Mehra; Christopher M O'Connor; Dwight Reynolds; Mary Norine Walsh; Clyde W Yancy Journal: Circulation Date: 2010-07-26 Impact factor: 29.690
Authors: Thomas Rutledge; Tanya S Kenkre; Diane V Thompson; Vera A Bittner; Kerry Whittaker; Jo-Ann Eastwood; Wafia Eteiba; Carol E Cornell; David S Krantz; Carl J Pepine; B Delia Johnson; Eileen M Handberg; C Noel Bairey Merz Journal: Am J Med Date: 2014-04-24 Impact factor: 4.965
Authors: Kimberley A Phillips; Karen L Bales; John P Capitanio; Alan Conley; Paul W Czoty; Bert A 't Hart; William D Hopkins; Shiu-Lok Hu; Lisa A Miller; Michael A Nader; Peter W Nathanielsz; Jeffrey Rogers; Carol A Shively; Mary Lou Voytko Journal: Am J Primatol Date: 2014-04-10 Impact factor: 2.371
Authors: Terese Sara Hoej Joergensen; Solvej Maartensson; Else Helene Ibfelt; Martin Balslev Joergensen; Ida Kim Wium-Andersen; Marie Kim Wium-Andersen; Eva Prescott; Per Kragh Andersen; Merete Osler Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2016-08-19 Impact factor: 4.328