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Depressive symptoms and treatment after acute coronary syndrome.

Ellis JJ, Eagle KA, Kline-Rogers EM, Erickson SR

Department of Pharmacy, Lincoln Surgical Hospital, Lincoln, NE, USA.

BACKGROUND: There is limited data regarding the effects of depression treatment adequacy on the mental component of health-related quality of life in a post-acute coronary syndrome population. METHODS: All patients diagnosed with an acute coronary syndrome and discharged from a university-affiliated hospital during a 3-year period were mailed a survey that included the SF-8, EQ-5D and other self-reported measures of disease and treatment (e.g. physical functioning, comorbidity, medication compliance and perceived cardiac severity). Patients were categorized based on self-report of depressive symptoms and antidepressant medication. Adjusted mean mental health-related quality of life scores were determined by least square mean analysis controlling for independent variables. RESULTS: Of 1217 eligible patients, 490 (40.3%) responded. Respondents averaged 65.2 (+/-11.3) years of age, 71% male, 92% Caucasian, 64% with MI history, 17% had their most recent cardiac event within 6 months. No depressive symptoms and no depression treatment (without depression) were reported by 59.8%, 27.6% reported untreated depressive symptoms (untreated), 8.6% reported depressive symptoms and antidepressant medication (undertreated), and 4.1% reported no symptoms and antidepressant medication (adequately treated). Adjusted mean SF-8 Mental Component Summary scores were 52.8, 52.5, 42.8 and 40.2 for patients without depression, adequately treated, untreated and undertreated, respectively (p<0.0001 for all pairwise comparisons except for patients without depression vs. adequately treated and untreated vs. undertreated). CONCLUSIONS: Depressive symptoms are common in patients diagnosed with acute coronary syndrome and appear to be related to lower mental health-related quality of life. These observations stress the importance of diagnosis and treatment of depression in this population.

Published 17 March 2005 in Int J Cardiol, 99(3): 443-7.
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