Depression in Cardiac Patients: Underrecognized and Undertreated

Depression occurs in 10% to 20% of post–myocardial infarction (MI) patients and 15% to 30% of heart failure (HF) patients. Depression has been associated with an increased risk of morbidity and mortality in these high-risk populations. Sertraline and citalopram are first-line antidepressants for post-MI patients; sertraline also has been proven safe for HF patients. It is unclear whether antidepressants improve cardiovascular (CV) outcomes. However, patients with improved depressive symptoms are more likely to be adherent to their cardiac medications and follow lifestyle modifications to reduce the likelihood of recurrent CV events. Pharmacists can play a pivotal role in screening cardiac patients for depression and educating them about their medications to improve clinical outcomes.