Trial findings contradict established acute coronary syndrome recommendations for depression screening

MANHASSET, N.Y., Oct. 21, 2019 /PRNewswire/ -- Systematic depression screening for survivors of acute coronary syndromes did not demonstrate patient benefit, according to The Feinstein Institutes for Medical Research Professor and Senior Vice President Karina W. Davidson, PhD, MASc. The findings, reported by Dr. Davidson, senior author of the JAMA Internal Medicine paper, runs counter to recommendations from professional societies and is based on results from a randomized clinical trial that included 1,500 survivors of acute coronary syndromes.

"Whether or not they were screened for depression, the 1,500 survivors who participated in the trial had no difference in their quality of life years or depression-free days. There was no difference found even when depression screening was followed by enhanced depression care," said Dr. Davidson. "These findings call into question that systematic depression screening of survivors of acute coronary syndromes will improve the overall health of these patients. It may be that selective screening and case finding would bring more benefit to those in need of depression treatment."

Acute coronary syndrome (ACS) patients with elevated depressive symptoms are at increased risk for recurrent cardiovascular events and mortality, poorer quality of life, and higher health care costs. These observational findings have prompted multiple scientific panels to advise screening for depression in all ACS survivors. To more definitively determine if universal or systematic screening for depression in ACS patients improves quality of life and depression as compared to usual care, Dr. Davidson and collaborators conducted a three-group multisite randomized trial that enrolled ACS patients from four health care systems between November 2013 and April 2017. 

Patients were eligible if they had been hospitalized for ACS in the previous two to 12 months and had no prior history of depression. In this randomized clinical trial that included 1,500 survivors of acute coronary syndromes, there were no differences in quality of life years or depression-free days in those who were and were not screened for depression, even when depression screening was followed by enhanced depression care.

"Dr. Davidson is a leader in assessing quality of life and outcomes for cardiac patients," said Kevin J. Tracey, MD, president and CEO of the Feinstein Institutes, "This study highlights the importance of new research into treating depression in these patients."

Dr. Davidson recently published a review regarding clinical practices for social determinants of health screening and referrals in the September 17, 2019 issue of The Journal of the American Medical Association (JAMA). Click here to read more.

About the Feinstein Institutes
The Feinstein Institutes for Medical Research is the research arm of Northwell Health, the largest health care provider and private employer in New York. Home to 50 research labs, 2,500 clinical research studies and 4,000 researchers and staff, the Feinstein Institutes is raising the standard of medical innovation through its five institutes of behavioral science, bioelectronic medicine, cancer, health innovations and outcomes, and molecular medicine. We're making breakthroughs in genetics, oncology, brain research, mental health, autoimmunity, and bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we're producing knowledge to cure disease, visit feinstein.northwell.edu.

SOURCE The Feinstein Institutes for Medical Research

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