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(Circulation. 2003;108:e9040.)
© 2003 American Heart Association, Inc.

Congress of the European Society of Cardiology, 2003

Robin Fox, FRCP

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Hearts and Minds

The voice of Sigmund Freud (1856–1939) was heard at the 2003 Congress of the European Society of Cardiology (ESC), held in his native city of Vienna, Austria. The great biologist and psychologist, had he been alive to attend, would doubtless have paid special attention to presentations on mental disturbance and the heart. An example is depression, an important risk factor for poor outcome after myocardial infarction (MI). At the Congress, a meta-analysis of the published work was reported by Dr J. Van Melle (University Hospital Groningen, Groningen, the Netherlands). His group identified 17 prospective studies of the impact of depression (assessed by established psychiatric methods) on mortality rate and cardiac events in the first 2 years after MI. The 17 studies described results in 3804 patients (12 cohorts), and the combined data pointed to an excess mortality risk of at least twice that of the nondepressed. Odds ratios (with 95% confidence intervals) were 2.58 (1.71 to 3.89) for all-cause mortality, 2.50 (1.71 to 3.68) for cardiac mortality, and 2.75 (1.41 to 5.34) for cardiac events. These results should dispel any residual doubts about the clinical importance of post-MI depression, and other work indicates that physicians can identify the condition with reasonable accuracy simply by asking, "Are you feeling blue or sad? Have you lost interest in your activities?" However, the kind of univariate analyses examined by Dr Van Melle tell us nothing about other relevant factors or even the direction of causation. For example, depression might act indirectly by lessening . . . [Full Text of this Article]