title: Relative associations between depression and anxiety on adverse cardiovascular events: does a history of coronary artery disease matter? A prospective observational study.
abstract: OBJECTIVE
  To assess whether depression and anxiety increase the risk of mortality and major adverse cardiovascular events (MACE), among patients with and without coronary artery disease (CAD).
  DECADE (Depression Effects on Coronary Artery Disease Events) is a prospective observational study of 2390 patients referred at the Montreal Heart Institute. Patients were followed for 8.8 years, between 1998 and 2009. Depression and anxiety were assessed using a psychiatric interview (Primary Care Evaluation of Mental Disorders, PRIME-MD). Outcomes data were obtained from Quebec provincial databases.
  
  
  METHODS
  All-cause mortality and MACE.
  
  
  RESULTS
  After adjustment for covariates, patients with depression were at increased risks of all-cause mortality (relative risk (RR)=2.84; 95% CI 1.25 to 6.49) compared with patients without depression. Anxiety was not associated with increased mortality risks (RR=0.86; 95% CI 0.31 to 2.36). When patients were stratified according to CAD status, depression increased the risk of mortality among patients with no CAD (RR=4.39; 95% CI 1.12 to 17.21), but not among patients with CAD (RR=2.32; 95% CI 0.78 to 6.88). Neither depression nor anxiety was associated with MACE among patients with or without CAD.
  
  
  CONCLUSIONS
  Depression, but not anxiety, was an independent risk factor for all-cause mortality in patients without CAD. The present study contributes to a better understanding of the relative and unique role of depression versus anxiety among patients with versus without CAD.
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Montréal, Québec, Canada.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Pelletier
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Research Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Department of Exercise Science, Concordia University, Montreal, Quebec, Canada.
authors.forename: Simon L
authors.identifier: http://orcid.org/0000-0001-7075-0358
authors.initials: SL
authors.lastname: Bacon
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada.
authors.forename: André
authors.initials: A
authors.lastname: Arsenault
authors.affiliation: Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Departement of Medicine, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Dupuis
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Research Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Laurin
authors.affiliation: Research Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada.
authors.forename: Lucie
authors.initials: L
authors.lastname: Blais
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Research Centre, Montreal Heart Institute- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Research Centre, Hôpital du Sacré-Cœur de Montréal- a University of Montreal affiliated Hospital, Montréal, Québec, Canada Department of Psychology, University of Québec at Montréal (UQAM), Montréal, Québec, Canada.
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
mesh_terms: D001007:Anxiety / Q000150:complications*; D002423:Cause of Death; D003324:Coronary Artery Disease / Q000150:complications* / Q000401:mortality / Q000523:psychology*; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
keywords: EPIDEMIOLOGY; MENTAL HEALTH