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Association between depressive symptoms and cardiovascular events in people with coronary heart disease largely due to physical inactivity

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Why is depression associated with an increased risk in cardiovascular events in people with stable coronary heart disease?


1017 outpatients (mean age 66 years) with coronary artery disease. Eligible participants were identified from administrative databases and had at least one of the following: a history of myocardial infarction, at least 50% stenosis in ⩾1 coronary vessel, evidence of exercise induced ischaemia, coronary revascularisation or diagnosis of coronary artery disease.


Outpatient setting: Department of Veterans Affairs Medical Centres, university medical centres and public health clinics, California, USA; recruitment September 2000 to December 2002.

Prognostic factors:

Depressive symptoms (Patient Health Questionnaire (PHQ) and Computerised Diagnostic Interview Schedule for the DSM-IV (C DIS-IV)), smoking, alcohol use and medication adherence (self-report questionnaire), physical activity (self-reported exercise intensity and exercise treadmill test), demographics (age, gender, ethnicity, education), medical history (self-report), body mass index (physical measure of height and weight), biological mediators (heart rate variability, norepinephrine and cortisol excretion, blood serotonin, C reactive protein (CRP), blood omega-3 fatty acids, docosahexaenoic acid and eicosapentaenoic acid), use of other medications, cardiac disease severity.


Cardiovascular events, including …

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