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Numerous studies have shown that depression is a risk factor for poor outcomes in cardiac disease, but few have explored possible mechanisms for the association. In a prospective cohort study, researchers linked baseline depressive symptoms on the nine-item Patient Health Questionnaire (PHQ-9) to subsequent cardiovascular events in 1017 outpatients with stable coronary heart disease (mean follow-up, 4.8 years).
Twenty percent of participants had depressive symptoms (PHQ-9 scores, ≥10); their annual age-adjusted rate of cardiac events was 10%, versus 6.7% in those with scores below this cutoff (hazard ratio, 1.50). Adjusting for medical- and cardiac-disease severity and for C-reactive protein levels reduced the HR to 1.24. Further adjustments…