title: An examination of the moderating effect of treatment with anti-depressants on the association of heart disease with depression in males with type 2 diabetes attending a Veterans Affairs Medical Center.
abstract: OBJECTIVE
  To examine the association of heart disease with depression and the impact of treatment with anti-depressants on this association in older males with type 2 diabetes.
  
  
  METHODS
  In this cross-sectional study, data were collected from the electronic medical record system of the Veterans Affairs Medical Center (VAMC) in a large mid-western city in the United States. Subjects were 8185 males older than 40, with a history of type 2 diabetes, who had visited the VAMC within the previous 6 years. Odds ratios were used to measure bivariate associations; multivariate logistic regression was used to adjust for potential confounding factors.
  
  
  RESULTS
  After adjustments for confounding variables, significant associations were found between depression and any adverse heart event (OR=1.34, p=0.001), coronary artery disease (OR=1.23, p=0.039), myocardial infarction (MI; OR=1.77, p<0.001), and angioplasty (OR=1.36, p=0.034). Examination of the interaction between depression and anti-depressant prescription status indicated that, except for MI, these associations were no longer significant among those who had been prescribed anti-depressants, but remained significant and were increased in magnitude among those who had not been prescribed anti-depressants.
  
  
  CONCLUSIONS
  These findings support the premise that co-morbid depression in diabetics is associated with the occurrence of adverse heart events, and further suggest that treatment of depression with anti-depressants moderates this association.
authors.affiliation: School of Medicine, University of Louisville, Louisville, KY, USA.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Higgins
authors.forename: Christine S
authors.initials: CS
authors.lastname: Ritchie
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Stetson
authors.forename: John D
authors.initials: JD
authors.lastname: Burke
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Looney
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology*; D003925:Diabetic Angiopathies / Q000150:complications / Q000523:psychology; D006331:Heart Diseases / Q000150:complications* / Q000188:drug therapy*; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States
chemical_list: D000928:Antidepressive Agents