Related Experiment Video
Updated: Jun 13, 2026
Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment
Published on: December 6, 2024
Enhanced depression care for patients with acute coronary syndrome and persistent depressive symptoms: coronary
Karina W Davidson1, Nina Rieckmann, Lynn Clemow
1Department of Medicine, Columbia University College of Physicians and Surgeons, PH9 Center, 622 W 168th St, Room 948, New York, NY 10032, USA. kd2124@columbia.edu
Insights
Enhanced depression care improved outcomes for patients with acute coronary syndrome (ACS). Patients receiving enhanced treatment reported higher satisfaction and fewer cardiac events, demonstrating improved prognosis.
Area of Science:
- Cardiology
- Psychiatry
- Clinical Research
Background:
- Depressive symptoms predict mortality and major adverse cardiac events (MACE) in acute coronary syndrome (ACS) patients.
- Enhanced depression treatment efficacy and acceptability in ACS patients were investigated.
Purpose of the Study:
- To determine the acceptability and efficacy of enhanced depression treatment in patients with ACS.
- To assess patient satisfaction, depressive symptom changes, MACE, and mortality.
Main Methods:
- A 6-month randomized controlled trial involving 237 ACS patients (157 depressed, 80 nondepressed).
- Depressed patients were randomized to enhanced depression care (problem-solving therapy/pharmacotherapy, stepped-care) or usual care.
- Outcomes included patient satisfaction, Beck Depression Inventory scores, MACE, and death.
Main Results:
- Higher patient satisfaction with depression care in the intervention group (54%) vs. usual care (19%).
- Significant reduction in depressive symptoms (Beck Depression Inventory) in the intervention group compared to usual care.
- A trend towards fewer major adverse cardiac events in the intervention group (4%) vs. usual care (13%).
Conclusions:
- Enhanced depression care is acceptable and effective for ACS patients.
- Improved patient satisfaction and reduced depressive symptoms were observed.
- Enhanced care shows a promising improvement in prognosis for ACS patients with depression.
Background:
Depressive symptoms are an established predictor of mortality and major adverse cardiac events (defined as nonfatal myocardial infarction or hospitalization for unstable angina or urgent/emergency revascularizations) in patients with acute coronary syndrome (ACS). This study was conducted to determine the acceptability and efficacy of enhanced depression treatment in patients with ACS.
Methods:
A 3-month observation period to identify patients with ACS and persistent depressive symptoms was followed by a 6-month randomized controlled trial. From January 1, 2005, through February 29, 2008, 237 patients with ACS from 5 hospitals were enrolled, including 157 persistently depressed patients randomized to intervention (initial patient preference for problem-solving therapy and/or pharmacotherapy, then a stepped-care approach; 80 patients) or usual care (77 patients) and 80 nondepressed patients who underwent observational evaluation. The primary outcome was patient satisfaction with depression care. Secondary outcomes were depressive symptom changes (assessed with the Beck Depression Inventory), major adverse cardiac events, and death.
Results:
At the end of the trial, the proportion of patients who were satisfied with their depression care was higher in the intervention group (54% of 80) than in the usual care group (19% of 77) (odds ratio, 5.4; 95% confidence interval [CI], 2.2-12.9 [P < .001]). The Beck Depression Inventory score decreased significantly more (t(155) = 2.85 [P = .005]) for intervention patients (change, -5.7; 95% CI, -7.6 to -3.8; df = 155) than for usual care patients (change, -1.9; 95% CI, -3.8 to -0.1; df = 155); the depression effect size was 0.59 of the standard deviation. At the end of the trial, 3 intervention patients and 10 usual care patients had experienced major adverse cardiac events (4% and 13%, respectively; log-rank test, chi(2)(1) = 3.93 [P = .047]), as well as 5 nondepressed patients (6%) (for the intervention vs nondepressed cohort, chi(2)(1) = 0.48 [P = .49]).
Conclusion:
Enhanced depression care for patients with ACS was associated with greater satisfaction, a greater reduction in depressive symptoms, and a promising improvement in prognosis.
Trial Registration:
clinicaltrials.gov Identifier: NCT00158054.
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:26Acute Coronary Syndrome V: Nursing Management
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Depressive Disorders: MDD and Dysthymia
01:25Antidepressant Drugs: Overview
01:18Depression: Overview