Table 1.

Summary of key trials of depression treatment in patients with cardiovascular disease

Study name	Participants	Intervention	Depression outcomes at end of treatment	Cardiovascular outcomes at follow-up	Notes
SADHART (Glassman et al. 2002) ⁴	369 Participants with depression after myocardial infarction or unstable angina	Sertraline (n = 186) Control: Placebo (n = 183) Duration: 24 weeks	Response rate: 67% sertraline, 53% placebo (P = 0.01)	No significant difference in major adverse cardiac events; 17& intervention, 22% control Follow-up: 24 weeks	Sertraline no different from placebo on measures of left ventricular ejection fraction, QTc prolongation and other measures of cardiovascular function or mortality
ENRICHD (Berkman et al. 2003) ⁹	1,834 Participants with depression after myocardial infarction	Cognitive behavioral therapy (CBT) + sertraline if insufficient response to CBT (n = 925) Control: Usual care (n = 909) Duration: 26 weeks	Change in HAM-D depression score: intervention -10, control - 8, p<.001	No significant difference in recurrent MI or death, 25 % intervention, 25% control Follow-up: 18 to 48 months	Only study powered to find a difference in cardiovascular outcomes as a result of treatment
CREATE A (Lesperance et al 2007) ⁵	284 Participants with depression and coronary artery disease	Intervention A: Interpersonal Psychotherapy + clinical management (n=142) Control A: Clinical management (n=142)	No benefit of interpersonal psychotherapy over clinical management	No significant difference in serious cardiovascular events, but only 12 total events Follow-up: 12 weeks	2X2 factorial design
CREATE B (Lesperance et al 2007) ⁵	284 Participants with depression and coronary artery disease	Intervention B: Citalopram (n=142) Control B: Placebo (n=142) Duration: 12 weeks	Response rate: 53% intervention, 40% control, P=0.03	No significant difference in serious cardiovascular events but only 12 total events Follow-up: 12 weeks	2X2 factorial design
Freedland et al. 2009 ¹⁰	123 Participants with depression within 1 year of coronary artery bypass graft	Intervention A: Cognitive behavioral therapy (n=41) Intervention B: Supportive stress management (n=42) Control A+B: Usual care (n=40) Duration: 12 weeks	Response rate: 71% CBT, 57% stress management; 33% usual care; p=0.002	Not assessed	Cognitive behavior therapy was superior to usual care at most later time points on secondary measures of depression, anxiety, hopelessness, stress, and quality of life
Bypassing the Blues (Rollman et al 2009) ¹¹	302 Participants with depression after coronary artery bypass graft	Intervention: Telephonebased collaborative depression care (n=150) Control: Usual care (n=152) Duration: 32 weeks	Response rate: 50% intervention, 30% control; p<.001	No significant difference in cardiac re- hospitalizations Follow-up: 32 weeks	Intervention patients also had significant improvements in mental health-related quality of life and physical functioning
COPES (Davidson et al 2010) ¹²	157 Participants with persistent depression after myocardial infarction or unstable angina	Intervention: Patient- preference, stepped care with problem solving therapy +/− antidepressants (n=80) Control: Usual care (n=77) Duration: 24 weeks	Change in BDI symptom score intervention −5.7, control −1.9, p<.001; effect size 0.59 (0.18-1.00)	Major adverse cardiac events/all-cause mortality 4% (n=3) intervention, 13% (n=10)control, p=0.046 Follow-up: 6 months	Satisfaction with depression care was higher in the intervention compared to usual care group (p<.001)