CONSIDERACIONES SOBRE LA DEPRESIÓN COMO FACTOR DE RIESGO EN PACIENTES CARDIOVASCULARES (Considerations of depression as a risk factor in cardiovascular patients)

Autores/as

  • Mariantonia Lemos Departamento de Psicología Escuela de Humanidades Universidad EAFIT
  • Diana María Agudelo Vélez Profesora Asociada Departamento de Psicología Universidad de los Andes

Resumen

Numerosos estudios han encontrado una asociación robusta entre los síntomas depresivos o la depresión mayor y un incremento en la morbilidad y la mortalidad cardiaca posterior a un síndrome coronario agudo (SCA); sin embargo, también se ha reportado evidencia en contra. Debido a esta divergencia, la depresión aún no ha sido aceptada por la Asociación Americana del Corazón como un factor de riesgo para un mal pronóstico en pacientes con enfermedades cardiovasculares. En este artículo se aborda el tema de la depresión en pacientes que han tenido un SCA y los factores que pueden influir en la divergencia de los resultados mencionada. Se concluye que la depresión se relaciona con un peor pronóstico en estos pacientes, específicamente cuando su presencia es posterior al evento o se trata de un cuadro resistente al tratamiento. Los síntomas cognitivos y somáticos son indicadores de mal pronóstico, así como la presencia de ansiedad comórbida.

Palabras clave: Depresión, Enfermedad Cardiovascular, Psicología de la Salud, Síndrome Coronario Agudo.

 

Abstract

Studies have found a strong association between depressive symptoms and major depression and cardiac morbidity and mortality increased after acute coronary syndrome (ACS); however it has also been reported evidence against this association. This difference in results may explain why depression has not yet been accepted by the American Heart Association as a risk factor for poor prognosis in patients with CVD. In this article depression is discussed as a risk factor of poor prognosis in patients who have had ACS and the factors that may influence the divergence of results in the studies. Our conclusions show that depression is related with a worse prognosis in ACS patients specifically when the symptomatology occurred after the event or when it is a treatment-resistant disorder. Cognitive and somatic symptoms and also comorbid anxiety are bad prognosis indicators.

 

Acute Coronary Syndrome, Cardiovascular Disease, Cardiovascular Disorders; Depression, Health Care Psychology, Health Psychology, Heart Disorders.

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Biografía del autor/a

Mariantonia Lemos, Departamento de Psicología Escuela de Humanidades Universidad EAFIT

Candidata a Doctora Universidad de los Andes

Diana María Agudelo Vélez, Profesora Asociada Departamento de Psicología Universidad de los Andes

Doctora en Psicología Clínica y de la Salud

Referencias bibliográficas

Alarcón, R., & Ramírez, E. (2006). Medicina psicosomática en enfermedad cardiovascular: consideraciones clínicas. Revista Colombiana de Psiquiatria, 35, 112-124.

Almeida, O. P., Alfonso, H., Flicker, L., Hankey, G. J., & Norman, P. E. (2011). Cardiovascular Disease, Depression and Mortality: The Health In Men Study. American Journal of Geriatric Psych, 20(5), 433 - 440. doi: 10.1097/JGP.0b013e318211c1ed

Barth, J., Schumacher, M., & Herrmann-Lingen, C. (2004). Depression as a Risk Factor for Mortality in Patients With Coronary Heart Disease: A Meta-analysis. Psychosomatic Medicine, 66(6), 802-813. doi: 10.1097/01.psy.0000146332.53619.b2

Bastidas-Bilbao, H., Gonzalez, A., & Castro, L. (2011). Propiedades psicométricas de las escalas BAS-DEP y EBAS_DEP en español para el tamizaje de depresión en una muestra geriátrica multisitio en Colombia: un estudio exploratorio. Acta colombiana de Psicología, 14(2), 129-137.

Berkman, L. F., Blumenthal, J., Burg, M., Carney, R. M., Catellier, D., Cowan, M. J., . . . Jaffe, A. (2003). Enhancing Recovery in Coronary Heart Disease Patients Investigators (ENRICHD). Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA, 289(23), 3106-3116. doi: 10.1001/jama.289.23.3106

Burg, M. M., & Abrams, D. (2001). Depression in chronic medical illness: The case of coronary heart disease. Journal of clinical psychology, 57(11), 1323-1337. doi: 10.1002/jclp.1100

Carney, R. M., Blumenthal, J. A., Freedland, K. E., Youngblood, M., Veith, R. C., Burg, M. M., . . . Czajkowski, S. M. (2004). Depression and late mortality after myocardial infarction in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study. Psychosomatic medicine, 66(4), 466-474. doi: 10.1097/01.psy.0000133362.75075.a6

Carney, R. M., & Freedland, K. E. (2008). Depression in patients with coronary heart disease. The American journal of medicine, 121(11 Suppl 2), S20-S27. doi: 10.1016/j.amjmed.2008.09.010

Carney, R. M., & Freedland, K. E. (2012a). Are Somatic Symptoms of Depression Better Predictors of Cardiac Events Than Cognitive Symptoms in Coronary Heart Disease? Psychosomatic Medicine, 74(1), 33-38. doi: 10.1097/PSY.0b013e3182405ac4

Carney, R. M., & Freedland, K. E. (2012b). Is there a high-risk subtype of depression in patients with coronary heart disease? Current psychiatry reports, 14(1), 1-7. doi: 10.1007/s11920-011-0247-6

Carney, R. M., Freedland, K. E., Steinmeyer, B. C., Blumenthal, J. A., Berkman, L. F., Watkins, L. L., . . . Jaffe, A. S. (2008). Depression and five year survival following acute myocardial infarction: a prospective study. Journal of affective disorders, 109(1), 133-138. doi: 10.1016/j.jad.2007.12.005

Carney, R. M., Freedland, K. E., & Veith, R. C. (2005). Depression, the autonomic nervous system, and coronary heart disease. Psychosomatic medicine, 67(Supplement 1), S29-S33. doi: 10.1097/01.psy.0000162254.61556.d5

Celano, C. M., Suarez, L., Mastromauro, C., Januzzi, J. L., & Huffman, J. C. (2013). Feasibility and Utility of Screening for Depression and Anxiety Disorders in Patients With Cardiovascular Disease. Circulation: Cardiovascular Quality and Outcomes. doi: 10.1161/CIRCOUTCOMES.111.000049

Cerezo, S., Hernández, M., Rodriguez, G., & Rivas, R. (2009). Efectos de una intervención de manejo de estrés en mujeres con hipertensión arterial sistémica. Acta Colombiana de Psicología, 12(1), 85-93.

Damen, N. L., Pelle, A. J., Boersma, E., Serruys, P. W., van Domburg, R. T., & Pedersen, S. S. (2013). Reduced positive affect (anhedonia) is independently associated with 7-year mortality in patients treated with percutaneous coronary intervention: results from the RESEARCH registry. European journal of preventive cardiology, 20(1), 127-134. doi: 10.1177/2047487312436452

Davidson, K. W., Burg, M. M., Kronish, I. M., Shimbo, D., Dettenborn, L., Mehran, R., . . . Lespérance, F. (2010). Association of anhedonia with recurrent major adverse cardiac events and mortality 1 year after acute coronary syndrome. Archives of general psychiatry, 67(5), 480 - 488. doi: 10.1001/archgenpsychiatry.2010.36

De Jonge, P., van den Brink, R. H. S., Spijkerman, T. A., & Ormel, J. (2006). Only Incident Depressive Episodes After Myocardial Infarction Are Associated With New Cardiovascular Events. Journal of the American College of Cardiology, 48(11), 2204-2208. doi: 10.1016/j.jacc.2006.06.077

Denollet, J., Freedland, K. E., Carney, R. M., de Jonge, P., & Roest, A. M. (2013). Cognitive-affective symptoms of depression after myocardial infarction: different prognostic importance across age groups. Psychosomatic medicine, 75(7), 701-708. doi: 10.1097/PSY.0b013e31829dbd36

Denollet, J., Pedersen, S. S., Daemen, J., De Jaegere, P., Serruys, P. W., & Van Domburg, R. T. (2008). Reduced positive affect (anhedonia) predicts major clinical events following implantation of coronary‐artery stents. Journal of internal medicine, 263(2), 203-211. doi: 10.1016/j.comppsych.2009.01.011

Di Benedetto, M., Lindner, H., Hare, D. L., & Kent, S. (2007). The role of coping, anxiety, and stress in depression post-acute coronary syndrome. Psychology, health & medicine, 12(4), 460-469. doi: 10.1080/13548500601109334

Dickens, C., Cherrington, A., Adeyemi, I., Roughley, K., Bower, P., Garrett, C., . . . Coventry, P. (2013). Characteristics of psychological interventions that improve depression in people with coronary heart disease: a systematic review and meta-regression. Psychosomatic medicine, 75(2), 211-221. doi: 10.1097/PSY.0b013e31827ac009

Dickens, C., Cherrington, A., & McGowan, L. (2012). Depression and health-related quality of life in people with coronary heart disease: a systematic review. European Journal of Cardiovascular Nursing, 11(3), 265-275. doi: 10.1177/1474515111430928

Dickens, C., McGowan, L., Percival, C., Tomenson, B., Cotter, L., Heagerty, A., & Creed, F. (2007). Depression Is a Risk Factor for Mortality After Myocardial InfarctionFact or Artifact? Journal of the American College of Cardiology, 49(18), 1834-1840. doi: 10.1016/j.jacc.2007.01.075

Dickens, C., McGowan, L., Percival, C., Tomenson, B., Cotter, L., Heagerty, A., & Creed, F. H. (2006). Contribution of depression and anxiety to impaired health-related quality of life following first myocardial infarction. The British Journal of Psychiatry, 189(4), 367-372. doi: 10.1192/bjp.bp.105.018234

Dowlati, Y., Herrmann, N., Swardfager, W., Liu, H., Sham, L., Reim, E. K., & Lanctôt, K. L. (2010). A meta-analysis of cytokines in major depression. Biological psychiatry, 67(5), 446-457. doi: 10.1016/j.biopsych.2009.09.033

Dunlop, D. D., Lyons, J. S., Manheim, L. M., Song, J., & Chang, R. W. (2004). Arthritis and heart disease as risk factors for major depression: the role of functional limitation. Medical care, 42(6), 502 - 511.

Everson, S. A., & Lewis, T. T. (2005). Psychosocial factors and cardiovascular diseases. Annu. Rev. Public Health, 26, 469-500. doi: 10.1146/annurev.publhealth.26.021304.144542

Frasure-Smith, N., & Lespérance, F. (2010). Depression and cardiac risk: present status and future directions. Postgraduate medical journal, 86(1014), 193-196. doi: 10.1136/hrt.2009.186957

Freedland, K. E., Skala, J. A., Carney, R. M., Raczynski, J. M., Taylor, C. B., Mendes-de-Leon, C. F., . . . Veith, R. C. (2002). The Depression Interview and Structured Hamilton (DISH): rationale, development, characteristics, and clinical validity. Psychosomatic Medicine, 64(6), 897-905. doi: 10.1097/01.PSY.0000028826.64279.29

Grace, S. L., Abbey, S. E., Kapral, M. K., Fang, J., Nolan, R. P., & Stewart, D. E. (2005). Effect of Depression on Five-Year Mortality After an Acute Coronary Syndrome. American Journal of Cardiology, 96(9), 1179-1185. doi: 10.1016/j.amjcard.2005.06.052

Guallar-Castillón, P., del Mar Magariños-Losada, M., Montoto-Otero, C., Tabuenca, A. I., Rodríguez-Pascual, C., Olcoz-Chiva, M., . . . Martínez-Morentín, E. (2006). Prevalencia de depresión, y factores biomédicos y psicosociales asociados, en ancianos hospitalizados con insuficiencia cardiaca en España. Revista española de cardiología, 59(8), 770-778. doi: 10.1157/13091880

Hare, D. L., Toukhsati, S. R., Johansson, P., & Jaarsma, T. (2014). Depression and cardiovascular disease: a clinical review. European heart journal, 35(21), 1365-1372. doi: 0.1093/eurheartj/eht462

Holahan, C. K., Moerkbak, M., & Suzuki, R. (2006). Social support, coping, and depressive symptoms in cardiac illness among Hispanic and non-Hispanic White cardiac patients. Psychology and Health, 21(5), 615-631. doi: 10.1080/14768320500457168

Huffman, J. C., Smith, F. A., Blais, M. A., Taylor, A. M., Januzzi, J. L., & Fricchione, G. L. (2008). Pre-Existing Major Depression Predicts In-Hospital Cardiac Complications After Acute Myocardial Infarction. Psychosomatics, 49(4), 309-316. doi: 10.1176/appi.psy.49.4.309
Jiang, W., Krishnan, R., Kuchibhatla, M., Cuffe, M. S., Martsberger, C., Arias, R. M., & O'Connor, C. M. (2011). Characteristics of Depression Remission and Its Relation With Cardiovascular Outcome Among Patients With Chronic Heart Failure (from the SADHART-CHF Study). The American journal of cardiology, 107(4), 545-551. doi: 10.1016/j.amjcard.2010.10.013

Jiang, W., O’Connor, C., Silva, S. G., Kuchibhatla, M., Cuffe, M. S., Callwood, D. D., . . . Krishnan, R. (2008). Safety and efficacy of sertraline for depression in patients with CHF (SADHART-CHF): a randomized, double-blind, placebo-controlled trial of sertraline for major depression with congestive heart failure. American heart journal, 156(3), 437. doi: 10.1016/j.ahj.2008.05.003

Kaptein, K. I., de Jonge, P., van den Brink, R. H., & Korf, J. (2006). Course of depressive symptoms after myocardial infarction and cardiac prognosis: a latent class analysis. Psychosomatic Medicine, 68(5), 662-668. doi: 10.1097/01.psy.0000233237.79085.57

Kendall-Tackett, K. (2009). Psychological trauma and physical health: A psychoneuroimmunology approach to etiology of negative health effects and possible interventions. Psychological Trauma: theory, research, practice, and policy, 1(1), 35-48. doi: 10.1037/a0015128

Kessing, D., Pelle, A. J., Kupper, N., Szabó, B. M., & Denollet, J. (2014). Positive affect, anhedonia, and compliance with self-care in patients with chronic heart failure. Journal of psychosomatic research, 77(4), 296-301. doi: 10.1016/j.psychores.2014.08.007

Lemos, M., Agudelo, D. M., Arango, J. C., & Rogers, H. L. (2013). Calidad de vida en pacientes con enfermedad cardiovascular: análisis de trayectorias por sexo y síntomas depresivos. Revista Nacional de Salud Pública, 31(1), 110-116.

Leroy, M., Loas, G., & Perez-Diaz, F. (2010). Anhedonia as predictor of clinical events after acute coronary syndromes: a 3-year prospective study. Comprehensive psychiatry, 51(1), 8-14. doi: 10.1016/j.comppsych.2009.01.011

Lespérance, F., Frasure-Smith, N., Koszycki, D., Laliberté, M.-A., van Zyl, L. T., Baker, B., . . . Dorian, P. (2007). Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease. JAMA: the journal of the American Medical Association, 297(4), 367-379. doi: 10.1001/jama.297.4.367

Leung, Y. W., Flora, D. B., Gravely, S., Irvine, J., Carney, R. M., & Grace, S. L. (2012). The Impact of Premorbid and Postmorbid Depression Onset on Mortality and Cardiac Morbidity Among Patients With Coronary Heart Disease: Meta-Analysis. Psychosomatic Medicine, 74(8), 786-801. doi: 10.1097/PSY.0b013e31826ddbed

Leventhal, H., Halm, E., Horowitz, C., Leventhal, E. A., & Ozakinci, G. (2004). Living with Chronic Illness: A Contextualized, Self-Regulation Approach. In S. Sutton, A. Baum, & M. Johnston (Eds.), The SAGE handbook of Health Psychology (pp. 197-240). Londres: SAGE publications.

Lichtman, J. H., Bigger, J. T., Blumenthal, J. A., Frasure-Smith, N., Kaufmann, P. G., Lespérance, F., . . . Froelicher, E. S. (2008). Depression and coronary heart disease. Circulation, 118(17), 1768-1775. doi: 10.1161/CIRCULATIONAHA.108.190769

Lichtman, J. H., Froelicher, E. S., Blumenthal, J. A., Carney, R. M., Doering, L. V., Frasure-Smith, N., . . . Wulsin, L. (2014). Depression as a Risk Factor for Poor Prognosis Among Patients With Acute Coronary Syndrome: Systematic Review and Recommendations: A Scientific Statement From the American Heart Association. Circulation. doi: 10.1161/CIR.0000000000000019
Lim, G. B. (2014). Risk factors: Depression recognized as a risk factor in ACS. Nature Reviews Cardiology, 11(4), 185-185. doi: 10.1038/nrcardio.2014.27

Linden, W., Phillips, M. J., & Leclerc, J. (2007). Psychological treatment of cardiac patients: a meta-analysis. European heart journal, 28(24), 2972-2984. doi: 10.1093/eurheartj/ehm504

Lippi, G., Montagnana, M., Favaloro, E. J., & Franchini, M. (2009). Mental depression and cardiovascular disease: a multifaceted, bidirectional association. Semin Thromb Hemost, 35(3), 325-336. doi: 10.1055/s-0029-1222611

Martens, E. J., Hoen, P. W., Mittelhaeuser, M., De Jonge, P., & Denollet, J. (2010). Symptom dimensions of post-myocardial infarction depression, disease severity and cardiac prognosis. Psychological Medicine, 40(5), 807-814. doi: 10.1017/S0033291709990997

Mavrides, N., & Nemeroff, C. (2013). Treatment of depression in cardiovascular disease. Depression and anxiety, 30(4), 328-341. doi: 10.1002/da.22051

Mayou, R. A., Gill, D., Thompson, D. R., Day, A., Hicks, N., Volmink, J., & Neil, A. (2000). Depression and anxiety as predictors of outcome after myocardial infarction. Psychosomatic medicine, 62(2), 212-219. doi: 8080/10.1037/t03589-000

McGuire, A. W., Eastwood, J.-A., Hays, R. D., Macabasco-O’Connell, A., & Doering, L. V. (2014). Depressed or Not Depressed: Untangling Symptoms of Depression in Patients Hospitalized With Coronary Heart Disease. American Journal of Critical Care, 23(2), 106-116. doi: 10.4037/ajcc2014146

Navarro-García, M. A., Marín-Fernández, B., de Carlos-Alegre, V., Martínez-Oroz, A., Martorell-Gurucharri, A., Ordoñez-Ortigosa, E., . . . Elizondo-Sotro, A. (2011). Trastornos del ánimo preoperatorios en cirugía cardiaca: factores de riesgo y morbilidad postoperatoria en la unidad de cuidados intensivos. Revista Española de Cardiología, 64(11), 1005 - 1010. doi: 10.1016/j.rec.2011.06.009

Parakh, K., Thombs, B. D., Fauerbach, J. A., Bush, D. E., & Ziegelstein, R. C. (2008). Effect of depression on late (8 years) mortality after myocardial infarction. The American journal of cardiology, 101(5), 602-606. doi: 10.1016/j.amjcard.2007.10.021

Parker, G. B., Hilton, T. M., Walsh, W. F., Owen, C. A., Heruc, G. A., Olley, A., . . . Hadzi-Pavlovic, D. (2008). Timing Is Everything: The Onset of Depression and Acute Coronary Syndrome Outcome. Biological Psychiatry, 64(8), 660-666. doi: 10.1016/j.biopsych.2008.05.021

Paz-Filho, G., Licinio, J., & Wong, M.-L. (2010). Pathophysiological basis of cardiovascular disease and depression: a chicken-and-egg dilemma. Revista Brasileira de Psiquiatria, 32, 181-191. doi: 10.1590/S1516-44462010000200015

Perez-Parada, J. (2011). Depression and cardiovascular disease: the need for improved case definition. Bulletin of Clinical Psychopharmacology, 21(1), 7-10.

Pitt, B., & Deldin, P. J. (2010). Depression and cardiovascular disease: have a happy day—just smile! European heart journal, 31(9), 1036-1037. doi: 10.1093/eurheartj/ehq031

Rafanelli, C., Sirri, L., Grandi, S., & Fava, G. A. (2013). Is Depression the Wrong Treatment Target for Improving Outcome in Coronary Artery Disease? Psychotherapy and psychosomatics, 82(5), 285-291. doi: 10.1159/000351586

Ramamurthy, G., Trejo, E., & Faraone, S. V. (2013). Depression treatment in patients with coronary artery disease: a systematic review. The Primary Care Companion for CNS Disorders, 15(5). doi: 10.4088/PCC.13r01509

Reddy, P., Dunbar, J. A., Morgan, M. A. J., & O'Neil, A. (2008). Coronary heart disease and depression: getting evidence into clinical practice. Stress and health, 24(3), 223-230. doi: 10.1002/smi.1201

Roest, A. M., Carney, R. M., Freedland, K. E., Martens, E. J., Denollet, J., & de Jonge, P. (2013). Changes in cognitive versus somatic symptoms of depression and event-free survival following acute myocardial infarction in the Enhancing Recovery In Coronary Heart Disease (ENRICHD) study. Journal of Affective Disorders, 149(1), 335-341. doi: 10.1016/j.jad.2013.02.008

Rogers, H. L., Nicholls, E., Lemos, M., Aristizabal, N., & Arango, J. C. (2013). Quality of life after a myocardial infarction: A one-year follow-up of Colombian coronary disease patients. Psychology and Health, 28(Sup. 1), 308. doi: 10.1080/08870446.2013.810851

Ruo, B., Rumsfeld, J. S., Hlatky, M. A., Liu, H., Browner, W. S., & Whooley, M. A. (2003). Depressive symptoms and health-related quality of life: the Heart and Soul Study. JAMA, 290(2), 215-221. doi: 10.1001/jama.290.2.215.

Scherrer, J. F., Chrusciel, T., Garfield, L. D., Freedland, K. E., Carney, R. M., Hauptman, P. J., . . . Lustman, P. J. (2012). Treatment-resistant and insufficiently treated depression and all-cause mortality following myocardial infarction. The British Journal of Psychiatry, 200(2), 137-142. doi: 10.1192/bjp.bp.111.096479

Schnatz, P. F., Nudy, M., Shively, C. A., Powell, A., & O'Sullivan, D. M. (2011). A prospective analysis of the association between cardiovascular disease and depression in middle-aged women. Menopause-the Journal of the North American Menopause Society, 18(10), 1096-1100. doi: 10.1097/gme.0b013e3182184928

Smith, P. J., & Blumenthal, J. A. (2011). Aspectos psiquiátricos y conductuales de la enfermedad cardiovascular: epidemiología, mecanismos y tratamiento. Revista Española de Cardiología, 64(10), 924 - 933. doi: 10.1016/j.recesp.2011.06.003

Smits, J. A., Minhajuddin, A., Thase, M. E., & Jarrett, R. B. (2012). Outcomes of acute phase cognitive therapy in outpatients with anxious versus nonanxious depression. Psychotherapy and psychosomatics, 81(3), 153-160. doi: 10.1159/000334909

Stewart, J. C., Perkins, A. J., & Callahan, C. M. (2014). Effect of Collaborative Care for Depression on Risk of Cardiovascular Events: Data From the IMPACT Randomized Controlled Trial. Psychosomatic medicine, 76(1), 29-37. doi: 10.1097/PSY.0000000000000022

Strik, J. J. M. H., Denollet, J., Lousberg, R., & Honig, A. (2003). Comparing symptoms of depression and anxiety as predictors of cardiac events and increased health care consumption after myocardial infarction. Journal of the American College of Cardiology, 42(10), 1801-1807. doi: 10.1016/j.jacc.2003.07.007

Thombs, B. D., Ziegelstein, R. C., Stewart, D. E., Abbey, S. E., Parakh, K., & Grace, S. L. (2008). Usefulness of persistent symptoms of depression to predict physical health status 12 months after an acute coronary syndrome. The American journal of cardiology, 101(1), 15-19. doi: 10.1016/j.amjcard.2007.07.043

Van Zyl, L. T., Lespérance, F., Frasure-Smith, N., Malinin, A. I., Atar, D., Laliberté, M.-A., & Serebruany, V. L. (2009). Platelet and endothelial activity in comorbid major depression and coronary artery disease patients treated with citalopram: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy Trial (CREATE) biomarker sub-study. Journal of thrombosis and thrombolysis, 27(1), 48-56. doi: 10.1007/s11239-007-0189-3

Watkins, L. L., Koch, G. G., Sherwood, A., Blumenthal, J. A., Davidson, J. R. T., O'Connor, C., & Sketch, M. H. (2013). Association of Anxiety and Depression With All‐Cause Mortality in Individuals With Coronary Heart Disease. Journal of the American Heart Association, 2(2), e000068. doi: 10.1161/JAHA.112.000068

White, M. L., & Groh, C. J. (2007). Depression and quality of life in women after a myocardial infarction. Journal of Cardiovascular Nursing, 22(2), 138-144. doi: 10.1097/00005082-200703000-00012

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2015-06-26

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Lemos, M., & Agudelo Vélez, D. M. (2015). CONSIDERACIONES SOBRE LA DEPRESIÓN COMO FACTOR DE RIESGO EN PACIENTES CARDIOVASCULARES (Considerations of depression as a risk factor in cardiovascular patients). CES Psicología, 8(1), 192–206. Recuperado a partir de https://revistas.ces.edu.co/index.php/psicologia/article/view/3333

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