Top

Published in:

01-10-2015 | Psychological Aspects of Cardiovascular Diseases (A Steptoe, Section Editor)

Depression in People with Coronary Heart Disease: Prognostic Significance and Mechanisms

Author: Chris Dickens

Published in: Current Cardiology Reports | Issue 10/2015

Abstract

Depression affects about 40 % of people with coronary heart disease (CHD). This group with depression and CHD have increased mortality and morbidity, worse health-related quality of life, use health services more frequently and consequently cost the health service and the national economy considerably more than their non-depressed counterparts. A number of characteristics of depression and plausible mechanisms have been proposed to explain this observed association, which could lead to improved understanding of the association and lead to new interventions to improve cardiac outcomes. This review summarises the evidence linking depression with worse cardiac outcomes, considers specific aspects of depression which may predict worse outcomes and reviews the mechanisms that could potentially explain the direct or indirect association of depression with coronary outcomes.

Nicholson A, Kuper H, Hemingway H. Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146,538 participants in 54 observational studies. Eur Heart J. 2006;27:2763–74.PubMedCrossRef

van Melle JP, de Jonge P, Spijkerman TA, et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med. 2004;66:814–22.PubMedCrossRef

de Jonge P, Spijkerman TA, van den Brink RH, et al. Depression after myocardial infarction is a risk factor for declining health related quality of life and increased disability and cardiac complaints at 12 months. Heart. 2006;92:32–9.PubMedCentralPubMedCrossRef

Dickens C, Cherrington A, McGowan L. Depression and health-related quality of life in people with coronary heart disease: a systematic review. Eur J Cardiovasc Nurs. 2012;11:265–75.PubMedCrossRef

Lauzon C, Beck CA, Huynh T, et al. Depression and prognosis following hospital admission because of acute myocardial infarction. CMAJ. 2003;168:547–52.PubMedCentralPubMed

Shiotani I, Sato H, Kinjo K, et al. Depressive symptoms predict 12 month prognosis in elderly patients with acute myocardial infarction. J Cardiovasc Risk. 2002;9:153–60.PubMed

Frasure-Smith N, Lesperance F, Gravel G, et al. Depression and health-care costs during the first year following myocardial infarction. J Psychosom Res. 2000;48:471–8.PubMedCrossRef

Kurdyak PA, Gnam WH, Goering P, et al. The relationship between depressive symptoms, health service consumption, and prognosis after acute myocardial infarction: a prospective cohort study. BMC Health Serv Res. 2008;8:200.PubMedCentralPubMedCrossRef

Pishgoo B. A novel prediction model for all cause emergency department visits in ischemic heart disease. J Res Med Sci. 2011;16:262–8.PubMedCentralPubMed

10.

Dickens C, Katon W, Blakemore A, et al. Does depression predict the use of urgent and unscheduled care by people with long term conditions? A systematic review with meta-analysis. J Psychosom Res. 2012;73:334–42.PubMedCrossRef

11.

Rutledge T, Vaccarino V, Johnson BD, et al. Depression and cardiovascular health care costs among women with suspected myocardial ischemia: prospective results from the WISE (Women's Ischemia Syndrome Evaluation) Study. J Am Coll Cardiol. 2009;53:176–83.PubMedCentralPubMedCrossRef

12.

O'Neil A, Sanderson K, Oldenburg B. Depression as a predictor of work resumption following myocardial infarction (MI): a review of recent research evidence. Health Qual Life Outcomes. 2010;8:95.PubMedCentralPubMedCrossRef

13.

Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosom Med. 2004;66:802–13.PubMedCrossRef

14.

Grace SL, Abbey SE, Kapral MK, et al. Effect of depression on five-year mortality after an acute coronary syndrome. Am J Cardiol. 2005;96:1179–85.PubMedCrossRef

15.

de Jonge P, van den Brink RH, Spijkerman TA, et al. Only incident depressive episodes after myocardial infarction are associated with new cardiovascular events. J Am Coll Cardiol. 2006;48:2204–8.PubMedCrossRef

16.

Dickens C, McGowan L, Percival C, et al. New onset depression following myocardial infarction predicts cardiac mortality. Psychosom Med. 2008;70:450–5.PubMedCrossRef

17.

Parker GB, Hilton TM, Walsh WF et al. Timing Is Everything: The Onset of Depression and Acute Coronary Syndrome Outcome. Biol Psychiatry. 2008.

18.

Lesperance F, Frasure-Smith N, Talajic M. Major depression before and after myocardial infarction: its nature and consequences. Psychosom Med. 1996;58:99–110.PubMedCrossRef

19.

Berkman LF, Blumenthal J, Burg M, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA. 2003;289:3106–16.PubMedCrossRef

20.•

Leung YW, Flora DB, Gravely S, et al. The impact of premorbid and postmorbid depression onset on mortality and cardiac morbidity among patients with coronary heart disease: meta-analysis. Psychosom Med. 2012;74:786–801. This paper presents a thorough overview of the importance of the timing of depression with regards to the effect of depression on cardaic outcomes.PubMedCentralPubMedCrossRef

21.

de Jonge P, Ormel J, van den Brink RH, et al. Symptom dimensions of depression following myocardial infarction and their relationship with somatic health status and cardiovascular prognosis. Am J Psychiatry. 2006;163:138–44.PubMedCrossRef

22.

Roest AM, Thombs BD, Grace SL, et al. Somatic/affective symptoms, but not cognitive/affective symptoms, of depression after acute coronary syndrome are associated with 12-month all-cause mortality. J Affect Disord. 2011;131:158–63.PubMedCrossRef

23.

Linke SE, Rutledge T, Johnson BD, et al. Depressive symptom dimensions and cardiovascular prognosis among women with suspected myocardial ischemia: A report from the National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation. Arch Gen Psychiatry. 2009;66:499–507.PubMedCentralPubMedCrossRef

24.

Martens EJ, Hoen PW, Mittelhaeuser M, et al. Symptom dimensions of post-myocardial infarction depression, disease severity and cardiac prognosis. Psychol Med. 2010;40:807–14.PubMedCrossRef

25.

Doyle F, Conroy R, McGee H, et al. Depressive symptoms in persons with acute coronary syndrome: specific symptom scales and prognosis. J Psychosom Res. 2010;68:121–30.PubMedCrossRef

26.

Smolderen KG, Spertus JA, Reid KJ, et al. The association of cognitive and somatic depressive symptoms with depression recognition and outcomes after myocardial infarction. Circ Cardiovasc Qual Outcomes. 2009;2:328–37.PubMedCentralPubMedCrossRef

27.

Hoen PW, Whooley MA, Martens EJ, et al. Differential associations between specific depressive symptoms and cardiovascular prognosis in patients with stable coronary heart disease. J Am Coll Cardiol. 2010;56:838–44.PubMedCentralPubMedCrossRef

28.

Frasure-Smith N, Lesperance F. Depression and other psychological risks following myocardial infarction. Arch Gen Psychiatry. 2003;60:627–36.PubMedCrossRef

29.

Hoen PW, Conradi HJ, Denollet J, et al. Interview-based ratings of somatic and cognitive symptoms of depression and their impact on cardiovascular prognosis. Psychother Psychosom. 2010;79:319–20.PubMedCrossRef

30.

Fava M, Davidson KG. Definition and epidemiology of treatment-resistant depression. Psychiatr Clin North Am. 1996;19:179–200.PubMedCrossRef

31.

Carney RM, Blumenthal JA, Freedland KE, et al. Depression and late mortality after myocardial infarction in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study. Psychosom Med. 2004;66:466–74.PubMedCrossRef

32.

Banankhah SK, Friedmann E, Thomas S. Effective treatment of depression improves post-myocardial infarction survival. World J Cardiol. 2015;7:215–23.PubMedCentralPubMed

33.

de Jonge P, Honig A, van Melle JP, et al. Nonresponse to treatment for depression following myocardial infarction: association with subsequent cardiac events. Am J Psychiatry. 2007;164:1371–8.PubMedCrossRef

34.

Glassman AH, Bigger Jr JT, Gaffney M. Psychiatric characteristics associated with long-term mortality among 361 patients having an acute coronary syndrome and major depression: seven-year follow-up of SADHART participants. Arch Gen Psychiatry. 2009;66:1022–9.PubMedCrossRef

35.

Stapelberg NJ, Neumann DL, Shum DH, et al. A topographical map of the causal network of mechanisms underlying the relationship between major depressive disorder and coronary heart disease. Aust N Z J Psychiatry. 2011;45:351–69.PubMedCrossRef

36.

Lehto S, Koukkunen H, Hintikka J, et al. Depression after coronary heart disease events. Scand Cardiovasc J. 2000;34:580–3.PubMedCrossRef

37.

Whooley MA, de Jonge P, Vittinghoff E, et al. Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA. 2008;300:2379–88.PubMedCentralPubMedCrossRef

38.

Ye S, Muntner P, Shimbo D, et al. Behavioral mechanisms, elevated depressive symptoms, and the risk for myocardial infarction or death in individuals with coronary heart disease: the REGARDS (Reason for Geographic and Racial Differences in Stroke) study. J Am Coll Cardiol. 2013;61:622–30.PubMedCentralPubMedCrossRef

39.

Anda RF, Williamson DF, Escobedo LG, et al. Depression and the dynamics of smoking. A national perspective. JAMA. 1990;264:1541–5.PubMedCrossRef

40.

Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220–9.PubMedCrossRef

41.

42.

Rutledge T, Kenkre TS, Thompson DV, et al. Depression, dietary habits, and cardiovascular events among women with suspected myocardial ischemia. Am J Med. 2014;127:840–7.PubMedPubMedCentralCrossRef

43.

Vogelzangs N, Kritchevsky SB, Beekman AT, et al. Depressive symptoms and change in abdominal obesity in older persons. Arch Gen Psychiatry. 2008;65:1386–93.PubMedCentralPubMedCrossRef

44.

Knol MJ, Twisk JW, Beekman AT, et al. Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia. 2006;49:837–45.PubMedCrossRef

45.

Bonnet F, Irving K, Terra JL, et al. Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis. 2005;178:339–44.PubMedCrossRef

46.

Allan JL, Johnston DW, Johnston M, et al. Depression and perceived behavioral control are independent predictors of future activity and fitness after coronary syndrome events. J Psychosom Res. 2007;63:501–8.PubMedCrossRef

47.

Brummett BH, Babyak MA, Siegler IC, et al. Effect of smoking and sedentary behavior on the association between depressive symptoms and mortality from coronary heart disease. Am J Cardiol. 2003;92:529–32.PubMedCrossRef

48.

Mayou RA, Gill D, Thompson DR, et al. Depression and anxiety as predictors of outcome after myocardial infarction. Psychosom Med. 2000;62:212–9.PubMedCrossRef

49.

Ziegelstein RC, Fauerbach JA, Stevens SS, et al. Patients with depression are less likely to follow recommendations to reduce cardiac risk during recovery from a myocardial infarction. Arch Intern Med. 2000;160:1818–23.PubMedCrossRef

50.

Carney RM, Freedland KE, Eisen SA, et al. Major depression and medication adherence in elderly patients with coronary artery disease. Health Psychol. 1995;14:88–90.PubMedCrossRef

51.•

Rieckmann N, Burg MM, Kronish IM, et al. Aspirin adherence, depression and one-year prognosis after acute coronary syndrome. Psychother Psychosom. 2011;80:316–8. Important study demonstrating that impact of depression on cardiac outcomes is partially mediated by compliance with prescribed medication.PubMedCentralPubMedCrossRef

52.

Sanderson BK, Bittner V. Women in cardiac rehabilitation: outcomes and identifying risk for dropout. Am Heart J. 2005;150:1052–8.PubMedCrossRef

53.

Casey E, Hughes JW, Waechter D, et al. Depression predicts failure to complete phase-II cardiac rehabilitation. J Behav Med. 2008;31:421–31.PubMedCrossRef

54.

Wang PS, Bohn RL, Knight E, et al. Noncompliance with antihypertensive medications: the impact of depressive symptoms and psychosocial factors. J Gen Intern Med. 2002;17:504–11.PubMedCentralPubMedCrossRef

55.

Collier DA, Stober G, Li T, et al. A novel functional polymorphism within the promoter of the serotonin transporter gene: possible role in susceptibility to affective disorders. Mol Psychiatry. 1996;1:453–60.PubMed

56.

Furlong RA, Ho L, Walsh C, et al. Analysis and meta-analysis of two serotonin transporter gene polymorphisms in bipolar and unipolar affective disorders. Am J Med Genet. 1998;81:58–63.PubMedCrossRef

57.

Nakatani D, Sato H, Sakata Y, et al. Influence of serotonin transporter gene polymorphism on depressive symptoms and new cardiac events after acute myocardial infarction. Am Heart J. 2005;150:652–8.PubMedCrossRef

58.

Comings DE, MacMurray JP, Gonzalez N, et al. Association of the serotonin transporter gene with serum cholesterol levels and heart disease. Mol Genet Metab. 1999;67:248–53.PubMedCrossRef

59.

McCaffery JM, Duan QL, Frasure-Smith N, et al. Genetic predictors of depressive symptoms in cardiac patients. Am J Med Genet B Neuropsychiatr Genet. 2009;150B:381–8.PubMedCentralPubMedCrossRef

60.

Danesh J, Whincup P, Walker M, et al. Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ. 2000;321:199–204.PubMedCentralPubMedCrossRef

61.

Ndrepepa G, Braun S, Cassese S, et al. C-reactive protein and prognosis in women and men with coronary artery disease after percutaneous coronary intervention. Cardiovasc Revasc Med. 2013;14:264–9.PubMedCrossRef

62.

Berton G, Palmieri R, Cordiano R, et al. Acute-phase inflammatory markers during myocardial infarction: association with mortality and modes of death after 7 years of follow-up. J Cardiovasc Med (Hagerstown). 2010;11:111–7.CrossRef

63.

Madjid M, Awan I, Willerson JT, et al. Leukocyte count and coronary heart disease: implications for risk assessment. J Am Coll Cardiol. 2004;44:1945–56.PubMedCrossRef

64.

Hemingway H, Philipson P, Chen R, et al. Evaluating the quality of research into a single prognostic biomarker: a systematic review and meta-analysis of 83 studies of C-reactive protein in stable coronary artery disease. PLoS Med. 2010;7:e1000286.PubMedCentralPubMedCrossRef

65.

Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009;71:171–86.PubMedCrossRef

66.

Gimeno D, Kivimaki M, Brunner EJ, et al. Associations of C-reactive protein and interleukin-6 with cognitive symptoms of depression: 12-year follow-up of the Whitehall II study. Psychol Med. 2009;39:413–23.PubMedCentralPubMedCrossRef

67.

Stewart JC, Rand KL, Muldoon MF, et al. A prospective evaluation of the directionality of the depression-inflammation relationship. Brain Behav Immun. 2009;23:936–44.PubMedCentralPubMedCrossRef

68.

Reichenberg A, Yirmiya R, Schuld A, et al. Cytokine-associated emotional and cognitive disturbances in humans. Arch Gen Psychiatry. 2001;58:445–52.PubMedCrossRef

69.

Wright CE, Strike PC, Brydon L, et al. Acute inflammation and negative mood: mediation by cytokine activation. Brain Behav Immun. 2005;19:345–50.PubMedCrossRef

70.

Abbott R, Whear R, Nikolaou V et al. Tumour necrosis factor-alpha inhibitor therapy in chronic physical illness: a systematic review and meta-analysis of the effect on depression and anxiety. J Psychosom Res. 2015.

71.

Beratis S, Katrivanou A, Georgiou S, et al. Major depression and risk of depressive symptomatology associated with short-term and low-dose interferon-alpha treatment. J Psychosom Res. 2005;58:15–8.PubMedCrossRef

72.

Musselman DL, Lawson DH, Gumnick JF, et al. Paroxetine for the prevention of depression induced by high-dose interferon alfa. N Engl J Med. 2001;344:961–6.PubMedCrossRef

73.

Miller AH. Norman Cousins Lecture. Mechanisms of cytokine-induced behavioral changes: psychoneuroimmunology at the translational interface. Brain Behav Immun. 2009;23:149–58.PubMedCentralPubMedCrossRef

74.

Miller GE, Freedland KE, Duntley S, et al. Relation of depressive symptoms to C-reactive protein and pathogen burden (cytomegalovirus, herpes simplex virus, Epstein-Barr virus) in patients with earlier acute coronary syndromes. Am J Cardiol. 2005;95:317–21.PubMedCrossRef

75.

Caro MA, Sowden GL, Mastromauro CA, et al. Risk factors for positive depression screens in hospitalized cardiac patients. J Cardiol. 2012;60:72–7.PubMedCrossRef

76.

Lesperance F, Frasure-Smith N, Theroux P, et al. The association between major depression and levels of soluble intercellular adhesion molecule 1, interleukin-6, and C-reactive protein in patients with recent acute coronary syndromes. Am J Psychiatry. 2004;161:271–7.PubMedCrossRef

77.

Nikkheslat N, Zunszain PA, Horowitz MA et al. Insufficient glucocorticoid signaling and elevated inflammation in coronary heart disease patients with comorbid depression. Brain Behav Immun. 2015.

78.

Schins A, Tulner D, Lousberg R, et al. Inflammatory markers in depressed post-myocardial infarction patients. J Psychiatr Res. 2005;39:137–44.PubMedCrossRef

79.

Steptoe A, Wikman A, Molloy GJ, et al. Inflammation and symptoms of depression and anxiety in patients with acute coronary heart disease. Brain Behav Immun. 2013;31:183–8.PubMedCrossRef

80.

Musselman DL, Tomer A, Manatunga AK, et al. Exaggerated platelet reactivity in major depression. Am J Psychiatry. 1996;153:1313–7.PubMedCrossRef

81.

Canan F, Dikici S, Kutlucan A, et al. Association of mean platelet volume with DSM-IV major depression in a large community-based population: the MELEN study. J Psychiatr Res. 2012;46:298–302.PubMedCrossRef

82.

Laghrissi-Thode F, Wagner WR, Pollock BG, et al. Elevated platelet factor 4 and beta-thromboglobulin plasma levels in depressed patients with ischemic heart disease. Biol Psychiatry. 1997;42:290–5.PubMedCrossRef

83.

Williams MS, Rogers HL, Wang NY, et al. Do platelet-derived microparticles play a role in depression, inflammation, and acute coronary syndrome? Psychosomatics. 2014;55:252–60.PubMedCentralPubMedCrossRef

84.

Cooper DC, Tomfohr LM, Milic MS, et al. Depressed mood and flow-mediated dilation: a systematic review and meta-analysis. Psychosom Med. 2011;73:360–9.PubMedCentralPubMedCrossRef

85.

Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002;106:2747–57.PubMedCrossRef

86.

Siscovick DS, Raghunathan TE, King I, et al. Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. JAMA. 1995;274:1363–7.PubMedCrossRef

87.

Kimmig LM, Karalis DG. Do omega-3 polyunsaturated fatty acids prevent cardiovascular disease? A review of the randomized clinical trials. Lipid Insights. 2013;6:13–20.PubMedCentralPubMed

88.

Levant B. N-3 (omega-3) polyunsaturated fatty acids in the pathophysiology and treatment of depression: pre-clinical evidence. CNS Neurol Disord Drug Targets. 2013;12:450–9.PubMedCentralPubMedCrossRef

89.

Frasure-Smith N, Lesperance F, Julien P. Major depression is associated with lower omega-3 fatty acid levels in patients with recent acute coronary syndromes. Biol Psychiatry. 2004;55:891–6.PubMedCrossRef

90.

Sontrop J, Campbell MK. Omega-3 polyunsaturated fatty acids and depression: a review of the evidence and a methodological critique. Prev Med. 2006;42:4–13.PubMedCrossRef

91.

Appleton KM, Rogers PJ, Ness AR. Updated systematic review and meta-analysis of the effects of n-3 long-chain polyunsaturated fatty acids on depressed mood. Am J Clin Nutr. 2010;91:757–70.PubMedCrossRef

92.

Martins JG. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. J Am Coll Nutr. 2009;28:525–42.PubMedCrossRef

93.

Ross BM, Seguin J, Sieswerda LE. Omega-3 fatty acids as treatments for mental illness: which disorder and which fatty acid? Lipids Health Dis. 2007;6:21.PubMedCentralPubMedCrossRef

94.

Sublette ME, Ellis SP, Geant AL, et al. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J Clin Psychiatry. 2011;72:1577–84.PubMedCentralPubMedCrossRef

95.

Bloch MH, Hannestad J. Omega-3 fatty acids for the treatment of depression: systematic review and meta-analysis. Mol Psychiatry. 2012;17:1272–82.PubMedCentralPubMedCrossRef

96.

Arborelius L, Owens MJ, Plotsky PM, et al. The role of corticotropin-releasing factor in depression and anxiety disorders. J Endocrinol. 1999;160:1–12.PubMedCrossRef

97.

Kaplan JR, Pettersson K, Manuck SB, et al. Role of sympathoadrenal medullary activation in the initiation and progression of atherosclerosis. Circulation. 1991;84:VI23–32.PubMedCrossRef

98.

Brown ES, Varghese FP, McEwen BS. Association of depression with medical illness: does cortisol play a role? Biol Psychiatry. 2004;55:1–9.PubMedCrossRef

99.

Jouven X, Zureik M, Desnos M, et al. Resting heart rate as a predictive risk factor for sudden death in middle-aged men. Cardiovasc Res. 2001;50:373–8.PubMedCrossRef

100.

Shaper AG, Wannamethee G, Macfarlane PW, et al. Heart rate, ischaemic heart disease, and sudden cardiac death in middle-aged British men. Br Heart J. 1993;70:49–55.PubMedCentralPubMedCrossRef

101.

Agelink MW, Boz C, Ullrich H, et al. Relationship between major depression and heart rate variability. Clinical consequences and implications for antidepressive treatment. Psychiatry Res. 2002;113:139–49.PubMedCrossRef

102.

Carney RM, Saunders RD, Freedland KE, et al. Association of depression with reduced heart rate variability in coronary artery disease. Am J Cardiol. 1995;76:562–4.PubMedCrossRef

103.

Carney RM, Blumenthal JA, Freedland KE, et al. Low heart rate variability and the effect of depression on post-myocardial infarction mortality. Arch Intern Med. 2005;165:1486–91.PubMedCrossRef

104.

Kamphuis MH, Geerlings MI, Dekker JM, et al. Autonomic dysfunction: a link between depression and cardiovascular mortality? The FINE Study. Eur J Cardiovasc Prev Rehabil. 2007;14:796–802.PubMedCrossRef

105.

Rottenberg J. Cardiac vagal control in depression: a critical analysis. Biol Psychol. 2007;74:200–11.PubMedCrossRef

Title: Depression in People with Coronary Heart Disease: Prognostic Significance and Mechanisms
Author: Chris Dickens
Publication date: 01-10-2015
Publisher: Springer US
Published in: Current Cardiology Reports / Issue 10/2015
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI: https://doi.org/10.1007/s11886-015-0640-6

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The STEP trials

Springer Medicine

Depression in People with Coronary Heart Disease: Prognostic Significance and Mechanisms

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2015

Management of Depression After Myocardial Infarction

Can a Closed Carotid Artery Be Reopened?

Stroke: Advances in Medical Therapy and Acute Stroke Intervention

Emotional Triggering of Cardiac Dysfunction: The Present and Future

Changing Contraindications for t-PA in Acute Stroke: Review of 20 Years Since NINDS

Cardiac Resynchronization Therapy Update: Evolving Indications, Expanding Benefit?

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page