NEW YORK (Reuters Health) – After the development of coronary artery disease (CAD), a subsequent diagnosis of depression is associated with an increased incidence of heart failure, even when antidepressant medication is used, according to findings from the Intermountain Heart Collaborative Study.

Although depression in heart failure is a recognized risk factor for adverse cardiovascular outcomes, Dr. Heidi T. May and co-authors state in the Journal of the American College of Cardiology for April 21, their prospective study is the first to assess whether depression following angiographic diagnosis of CAD is associated with heart failure onset.

Included were 13,708 patients (mean age 64 years) with no antecedent diagnosis of depression or heart failure or use of antidepressants at the time of the index angiography. Depression was later diagnosed in 1377, and heart failure in 674.

The incidence of heart failure per 100 patients was 3.6 among those without a post-CAD depression diagnosis and 16.4 for those with such a diagnosis, the authors report.

In multivariate analysis, depression without or with antidepressant use was associated with heart failure, after adjustment for baseline factors, medications, and follow-up MI (adjusted hazard ratios 1.68 and 2.00, respectively; p < 0.0001 for both).