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Anhedonia predicts adverse cardiac events in people with acute coronary syndromes

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Does anhedonia and/or depressed mood predict recurrent major adverse cardiac events (MACEs) in people with acute coronary syndromes (ACS)?


Consecutive sample of 453 people (58% male, mean age 61 years, range 25–93 years) hospitalised for ACS: 21% with acute myocardial infarction with ST-segment elevation, 33% with acute myocardial infarction without ST-segment elevation and 46% with unstable angina. To be included, participants had to either be not depressed (scoring 0–4 on the Beck Depression Inventory, BDI) or have at least mild depression (scoring ≥10 on the BDI). People scoring 5–9 on the BDI were excluded to delineate clearly between depressed and non-depressed people. Main exclusions were terminal illness, cognitive impairment and alcohol or substance abuse, being unavailable for follow-up or screening not completed in the first week.


Cardiac units in three university hospitals, New York and Connecticut, USA; recruitment May 2003 to June 2005.

Prognostic factors

Anhedonia and depressed mood (clinical or patient assessed), depressive symptoms severity (BDI score <5 vs ≥10), major depressive episodes (MDEs). Participants had a semistructured diagnostic interview 1 week after admission for ACS. The interview assessed anhedonia, depressed mood and Diagnostic and Statistical Manual, Fourth Edition MDEs. Symptoms had …

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  • Sources of funding National Heart Lung and Blood Institute (grants HC-25197, HL-076857, HL-084034m HL-04458).


  • Competing interests None.

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