Vaccarino2020 - Depression and coronary heart disease, 2018 position paper of the ESC working group on coronary pathophysiology and microcirculation

  • Type:#article
  • Date read: 2022-09-01
  • Subject: Depression
  • Bibtex: @vaccarino2020
  • Bibliography: Vaccarino, V., Badimon, L., Bremner, J. D., Cenko, E., Cubedo, J., Dorobantu, M., Duncker, D. J., Koller, A., Manfrini, O., Milicic, D., Padro, T., Pries, A. R., Quyyumi, A. A., Tousoulis, D., Trifunovic, D., Vasiljevic, Z., de Wit, C., Bugiardini, R., & ESC Scientific Document Group Reviewers. (2020). Depression and coronary heart disease: 2018 position paper of the ESC working group on coronary pathophysiology and microcirculation. European Heart Journal, 41(17), 1687–1696.

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Key takeaways

  • Depression common in coronary heart disease (CHD), and an important risk factor
  • The article reviews potential mechanisms why depression is a risk factor for CHD
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“Det här är ett ESC position paper från 2018 om Dep och CVD, läs denna! Vi behöver ha med den i artikeln, gärna tidigt i intro samt i diskussionen”

Lägg in bredvid refs 12, 13

Author recommendations

  • Clinicians should be aware of the high prevalence of depression in CHD (coronary heart disease) patients. Screening for depression is recommended if patients have access to adequate care support systems
  • Patients with positive screening results should be referred to a qualified health care provider in the management of depression
  • Non-pharmacologic interventions such as exercise and psychotherapy should be considered as additional treatment options for CHD patients
  • Harmonization of care between healthcare providers is essential in patients with combined CHD and depression

Converging evidence from both experimental and epidemiological studies indicates that there is a bidirectional association between depression and CHD. Depression is very common in patients with CHD and is an independent risk factor for poorer CHD outcomes. The underlying mechanisms linking depression and worse CHD outcomes are complex and potentially multifactorial. Further research is necessary to elucidate them. Nonetheless, there is growing consensus for considering depression as a modifiable prognostic factor for CHD, and for the need of improved efforts towards better recognition and management of this problem in the clinical practice of cardiology.3,4 Whether effective and safe treatment of depression may improve CHD outcomes, and whether specific patient subgroups may benefit more from such treatments, require further evaluation.