Does treatment of depression improve prognosis after heart attack?
In recent years, much attention has been given to depression following heart attack and its effects on prognosis. Several large scale studies have been undertaken (ENRICHD, SADHART, MIND-IT, CREATE) in which depression was targeted. Although we hoped that treating depression would result in an improved prognosis, these studies have not provided much evidence to support this position: effects on depression itself have been minor and did not translate into cardiovascular benefits. One of the reasons for these findings may be the heterogeneity of depression following heart attack, with some depression types being cardiotoxic and responding to treatment, and others not. Two studies are discussed that were carried out across several hospitals in the Netherlands that will help us to understand the intriguing relation between depression and heart disease. 2,466 heart attack patients were assessed on depression and clinical characteristics during hospitalization and followed for more than 2.5
