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Depression and the risk of coronary heart disease: a meta-analysis of prospective cohort studies.

Gan Y, Gong Y, Tong X, Sun H, Cong Y, Dong X, Wang Y, Xu X, Yin X, Deng J, Li L, Cao S, Lu Z - BMC Psychiatry (2014)

Bottom Line: Either a random-effects model or fixed-effects model was used to compute the pooled risk estimates when appropriate.In the subgroup analysis by follow-up duration, the RR of CHD was 1.36 (95% CI, 1.24-1.49) for less than 15 years follow-up, and 1.09 (95% CI, 0.96-1.23) for equal to or more than 15 years follow-up.Potential publication bias may exist, but correction for this bias using trim-and-fill method did not alter the combined risk estimate substantially.

View Article: PubMed Central - PubMed

Affiliation: Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China. scswj2008@163.com.

ABSTRACT

Background: Several systematic reviews and meta-analyses demonstrated the association between depression and the risk of coronary heart disease (CHD), but the previous reviews had some limitations. Moreover, a number of additional studies have been published since the publication of these reviews. We conducted an updated meta-analysis of prospective studies to assess the association between depression and the risk of CHD.

Methods: Relevant prospective studies investigating the association between depression and CHD were retrieved from the PubMed, Embase, Web of Science search (up to April 2014) and from reviewing reference lists of obtained articles. Either a random-effects model or fixed-effects model was used to compute the pooled risk estimates when appropriate.

Results: Thirty prospective cohort studies with 40 independent reports met the inclusion criteria. These groups included 893,850 participants (59,062 CHD cases) during a follow-up duration ranging from 2 to 37 years. The pooled relative risks (RRs) were 1.30 (95% CI, 1.22-1.40) for CHD and 1.30 (95% CI, 1.18-1.44) for myocardial infarction (MI). In the subgroup analysis by follow-up duration, the RR of CHD was 1.36 (95% CI, 1.24-1.49) for less than 15 years follow-up, and 1.09 (95% CI, 0.96-1.23) for equal to or more than 15 years follow-up. Potential publication bias may exist, but correction for this bias using trim-and-fill method did not alter the combined risk estimate substantially.

Conclusions: The results of our meta-analysis suggest that depression is independently associated with a significantly increased risk of CHD and MI, which may have implications for CHD etiological research and psychological medicine.

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Related in: MedlinePlus

Flow chart of study selection.
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Fig1: Flow chart of study selection.

Mentions: Initially, 9022 articles from the PubMed, Embase, and Web of Science were identified. The majority were excluded after the first screening of titles or abstracts, because they were duplicates, reviews, case–control studies, cross-sectional studies, or not relevant to our analysis. After assessing full texts for detailed evaluation, 30 studies [23-52] met the inclusion criteria and were included in the meta-analysis. A flow chart showing the study selection was presented in Figure 1. Interobserver agreement (κ) was 0.959, which indicated a very outstanding concordance between raters for article inclusion decisions [53]. The quality of studies was generally good, with results of study quality assessment yielded a score of 6 or above for all included studies, with an average score of 7.8.Figure 1


Depression and the risk of coronary heart disease: a meta-analysis of prospective cohort studies.

Gan Y, Gong Y, Tong X, Sun H, Cong Y, Dong X, Wang Y, Xu X, Yin X, Deng J, Li L, Cao S, Lu Z - BMC Psychiatry (2014)

Flow chart of study selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4336481&req=5

Fig1: Flow chart of study selection.
Mentions: Initially, 9022 articles from the PubMed, Embase, and Web of Science were identified. The majority were excluded after the first screening of titles or abstracts, because they were duplicates, reviews, case–control studies, cross-sectional studies, or not relevant to our analysis. After assessing full texts for detailed evaluation, 30 studies [23-52] met the inclusion criteria and were included in the meta-analysis. A flow chart showing the study selection was presented in Figure 1. Interobserver agreement (κ) was 0.959, which indicated a very outstanding concordance between raters for article inclusion decisions [53]. The quality of studies was generally good, with results of study quality assessment yielded a score of 6 or above for all included studies, with an average score of 7.8.Figure 1

Bottom Line: Either a random-effects model or fixed-effects model was used to compute the pooled risk estimates when appropriate.In the subgroup analysis by follow-up duration, the RR of CHD was 1.36 (95% CI, 1.24-1.49) for less than 15 years follow-up, and 1.09 (95% CI, 0.96-1.23) for equal to or more than 15 years follow-up.Potential publication bias may exist, but correction for this bias using trim-and-fill method did not alter the combined risk estimate substantially.

View Article: PubMed Central - PubMed

Affiliation: Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China. scswj2008@163.com.

ABSTRACT

Background: Several systematic reviews and meta-analyses demonstrated the association between depression and the risk of coronary heart disease (CHD), but the previous reviews had some limitations. Moreover, a number of additional studies have been published since the publication of these reviews. We conducted an updated meta-analysis of prospective studies to assess the association between depression and the risk of CHD.

Methods: Relevant prospective studies investigating the association between depression and CHD were retrieved from the PubMed, Embase, Web of Science search (up to April 2014) and from reviewing reference lists of obtained articles. Either a random-effects model or fixed-effects model was used to compute the pooled risk estimates when appropriate.

Results: Thirty prospective cohort studies with 40 independent reports met the inclusion criteria. These groups included 893,850 participants (59,062 CHD cases) during a follow-up duration ranging from 2 to 37 years. The pooled relative risks (RRs) were 1.30 (95% CI, 1.22-1.40) for CHD and 1.30 (95% CI, 1.18-1.44) for myocardial infarction (MI). In the subgroup analysis by follow-up duration, the RR of CHD was 1.36 (95% CI, 1.24-1.49) for less than 15 years follow-up, and 1.09 (95% CI, 0.96-1.23) for equal to or more than 15 years follow-up. Potential publication bias may exist, but correction for this bias using trim-and-fill method did not alter the combined risk estimate substantially.

Conclusions: The results of our meta-analysis suggest that depression is independently associated with a significantly increased risk of CHD and MI, which may have implications for CHD etiological research and psychological medicine.

Show MeSH
Related in: MedlinePlus