Comorbid depression and health-related quality of life in patients with coronary artery disease

OBJECTIVE

This article reviews recent studies relating to the impact of depression and its treatment on the health-related quality of life (HRQOL) of patients with coronary artery disease (CAD).

METHODS

Articles for the primary review were identified via MEDLINE and PsycINFO (1995-2006).

RESULTS

Evidence suggests that depression has an aversive impact on the HRQOL of patients with stable CAD as well as on patients hospitalized for acute myocardial infarction and coronary artery bypass graft surgery. Unfortunately, there are few depression treatment studies in patients with CAD that make use of standardized HRQOL measures, but the limited evidence suggests that successful treatment has positive implications for HRQOL in these patients. The mechanisms through which depression impacts on HRQOL require further study but are likely to be behavioral.

CONCLUSIONS

Depressive symptoms significantly undermine HRQOL in patients with CAD despite successful medical and surgical management. Although successful treatment of depression has not been shown to reduce mortality rates in patients with CAD, further study may find that the HRQOL benefits of such treatment are equally valuable.

Quality of life in patients with coronary artery disease and the impact of depression

Depression has been shown to be a risk factor for the development of coronary artery disease, and also is associated with greater risk of mortality in patients with coronary disease. Treatment of depression may or may not prove to alter depression as a risk factor, but improving the quality of life (QOL) of patients with coronary disease also should be considered a primary outcome. Quality of life is a difficult concept to define and measure. However, recent investigations in patients with coronary disease have examined the relationship of QOL to mortality risk and depression. This article will review the concept and measurement of QOL, discuss studies of factors that predict QOL in patients with coronary artery disease, and focus on the impact of depression on QOL.