title: Depression as a risk factor for acute coronary syndrome: a review.
abstract: OBJECTIVE
  In the past few years more and more research focused on psychosocial risk factors of cardiovascular disease, including depression. This review focuses on depression as a long-term risk factor for acute coronary syndrome in initially heart disease-free people.
  
  
  METHODS
  The studies included (n = 15) comprised people without heart disease who were exposed to depression. The outcome was acute coronary syndrome (acute myocardial infarction, instable angina pectoris, sudden cardiac death). Only articles published in English between 2000 and 2013 were considered.
  
  
  RESULTS
  Most but not all studies found an association between depression and cardiac outcome. Possible explanations for the inconsistency of the findings are discussed.
  
  
  CONCLUSIONS
  Most likely there is an association between depression and acute coronary syndrome. However, it remains unclear whether depression acts as an independent risk factor for developing an acute coronary syndrome, or if depression promotes the development of an acute coronary syndrome by indirect means.
authors.affiliation: Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Inselspital Bern, Effingerstrasse 102, 3010, Bern, Switzerland.
authors.forename: Genny S
authors.initials: GS
authors.lastname: Misteli
authors.forename: Petra
authors.initials: P
authors.lastname: Stute
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology*; D000787:Angina Pectoris / Q000209:etiology; D003863:Depression / Q000150:complications*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D012307:Risk Factors