Randomized Trial of Depression Screening After Acute Coronary Syndromes - CODIACS-QOL
Contribution To Literature:
The CODIACS-QOL trial failed to show that screening for depression after acute coronary syndrome was beneficial.
The goal of the trial was to evaluate depression screening compared with no screening among patients with recent acute coronary syndrome.
Patients with recent acute coronary syndrome were randomized to depression screening/notification of results/treatment (n = 499) versus depression screening/notification of results (n = 501) versus no screening (n = 500).
- Total number of enrollees: 1,500
- Duration of follow-up: 18 months
- Mean patient age: 66 years
- Percentage female: 28%
- Patients ≥21 years of age with acute coronary syndrome within the last 2-12 months
- Prior or current depression
- Limited life expectancy
- Severe mental illness
- Severe physical illness
Other salient features/characteristics:
- Positive screen for depression: 7.6% of the screen/notify/treat group and 6.6% of the screen/notify
There was no difference in the change in quality-adjusted life-years from baseline to 18 months between the three groups (p = 0.91).
- No difference in the change in depression-free days from baseline to 18 months between the three groups (p = 0.63)
- No difference in mortality at 18 months between the three groups (p = not significant)
Among patients with recent acute coronary syndrome, screening for depression was not beneficial. This intervention failed to improve quality-adjusted life-years or depression-free days compared with no screening. Approximately 6-7% of individuals were screened for depression. Depression screening guidelines may need to be reconsidered.
Presented by Dr. Ian Matthew Kronish at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, March 16, 2019.
Keywords: ACC Annual Scientific Session, ACC19, Acute Coronary Syndrome, Depression, Quality of Life, Secondary Prevention, Treatment Outcome
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