LocationMontreal Heart Institute
CategoryCardiology, Cardiovascular disease
Studies have shown that patients with coronary artery disease (CAD) have higher levels of depression compared to the general population. CAD patients who are depressed may be at higher risk for cardiac events (e.g., myocardial infarction, MI) and mortality compared to CAD patients who are not depressed. However, many of the studies on which these findings are based were conducted in patients right after a major cardiac event (e.g., MI), which makes it difficult to know how much future risk was due to depression and how much future risk was due to the seriousness of the MI. Also, many of these studies only evaluated depressive symptoms, which may not have the same clinical significance as more severe, clinical levels of depression. To resolve these issues, we need to evaluate the impact of clincial depression vs. depressive symptoms on risk for mortality and cardiac events in a sample of stable outpatients who have not just suffered a major cardiac event. To assess the impact of depression level on both the development and progression of CAD, it would be useful to study a sample of patients with and without known CAD. That is the main purpose of the DECADE study.
Positive results would more firmly establish at what level and at what stage in the CAD process depression has the greatest impact on CAD outcomes, which may in turn, encourage and ultimately convince physicians to assess and treat depression at an early enough stage of disease to make a significant prognostic impact.
Heart and Stroke Foundation of Quebec
- Lavoie KL, Paine NJ, Pelletier R, Arsenault A, Diodati JG, Campbell TS, Pilote L, Bacon SL. (2018). Relationship between antidepressant therapy and risk for cardiovascular events in patients with and without cardiovascular disease. Health Psychology, 37(11): 989-999.
- Paine NJ, Bacon SL, Pelletier R, Arsenault A, Diodati JG, Lavoie KL. (2016). Do women with anxiety or depression have higher rates of myocardial ischemia during exercise testing than men? Circulation: Cardiovascular Quality and Outcomes, 9: S53-61.
- Pelletier R, Bacon SL, Arsenault A, Dupuis J, Laurin C, Blais L, Lavoie KL. (2015). The Relative Associations between Depression and Anxiety on Adverse Cardiovascular Events: Does a History of Coronary Artery Disease Matter? A Prospective Observational Study. BMJ Open, 5: e006582.
- Lavoie KL, Fleet PP, Lesperance F, Laurin C, Arsenault A, Frasure-Smith N, Burelle D, Bacon SL. (2004). Are exercise stress tests appropriate for assessing myocardial ischemia in patients with major depressive disorder? American Heart Journal, 148: 621-627.
- Lavoie KL, Fleet RP, Laurin C, Arsenault A, Miller SB, Bacon SL. (2004). Heart rate variability in coronary artery disease patients with and without panic disorder. Psychiatry Research, 128: 289-299.