title: Effects of depression co-morbidity and treatment on quality of life in patients with acute coronary syndrome: the Korean depression in ACS (K-DEPACS) and the escitalopram for depression in ACS (EsDEPACS) study.
abstract: BACKGROUND
  Depression is common after acute coronary syndrome (ACS) with adverse effects on prognosis. There is little evidence on whether depression treatment improves quality of life (QoL) in ACS patients. The aim of this study was to investigate the effects of co-morbid depression and its treatment on QoL in ACS.
  
  
  METHODS
  In total, 1152 patients were recruited at baseline, 2-14 weeks after a confirmed ACS episode, and 828 were followed 1 year thereafter. Of 446 baseline participants with co-morbid depressive disorders, 300 were randomized to a 24-week double blind trial of escitalopram or placebo, while the remaining 146 received medical treatment only (MTO). QoL was measured by the World Health Organization Quality of Life -Abbreviated form (WHOQOL-BREF).
  
  
  RESULTS
  At baseline, QoL was significantly lower in patients with co-morbid depressive disorder than those without. QoL improvement was significantly greater in those receiving escitalopram than those receiving placebo over the 24-week treatment period. In the 1-year follow-up, the better outcomes associated with escitalopram remained evident against both placebo and MTO.
  
  
  CONCLUSIONS
  Depression was significantly associated with worse QoL even in patients with recently developed ACS. Depression treatment was associated with QoL improvement in ACS patients in the 24-week treatment period, the effects of which extended to 1 year.
authors.affiliation: Department of Psychiatry,Chonnam National University Medical School, andDepression Clinical Research Center,Chonnam National University Hospital,Gwangju,Korea.
authors.forename: J-M
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Institute of Psychiatry,King's College London,London,UK.
authors.forename: R
authors.initials: R
authors.lastname: Stewart
authors.affiliation: Department of Psychiatry,Chonnam National University Medical School, andDepression Clinical Research Center,Chonnam National University Hospital,Gwangju,Korea.
authors.forename: K-Y
authors.initials: KY
authors.lastname: Bae
authors.affiliation: Department of Psychiatry,Chonnam National University Medical School, andDepression Clinical Research Center,Chonnam National University Hospital,Gwangju,Korea.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: Department of Psychiatry,Chonnam National University Medical School, andDepression Clinical Research Center,Chonnam National University Hospital,Gwangju,Korea.
authors.forename: S-W
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Psychiatry,Chonnam National University Medical School, andDepression Clinical Research Center,Chonnam National University Hospital,Gwangju,Korea.
authors.forename: I-S
authors.initials: IS
authors.lastname: Shin
authors.affiliation: Department of Cardiology,Chonnam National University Medical School, andDepression Clinical Research Center,Chonnam National University Hospital,Gwangju,Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Department of Cardiology,Chonnam National University Medical School, andDepression Clinical Research Center,Chonnam National University Hospital,Gwangju,Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Department of Cardiology,Chonnam National University Medical School, andDepression Clinical Research Center,Chonnam National University Hospital,Gwangju,Korea.
authors.forename: M H
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Department of Psychiatry,Chonnam National University Medical School, andDepression Clinical Research Center,Chonnam National University Hospital,Gwangju,Korea.
authors.forename: J-S
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000523:psychology; D015283:Citalopram / Q000627:therapeutic use*; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors
keywords: randomized controlled trial