Estimating the prevalence of depression in people with acute coronary syndromes: A systematic review and meta-analysis

Abstract

Background: The epidemic of acute coronary syndromes (ACS) poses a great challenge to depression. However, the prevalence of depression among ACS patients has not been fully determined. This meta-analysis aimed to provide an estimation of the global prevalence of depression among ACS patients (ACS depression). Methods: Online databases including PubMed, Cochrane Library, Web of Science, and Scopus were searched for all relevant studies that reported the prevalence of ACS depression through March 2023. Pooled prevalence of ACS depression with 95% confidence interval (CI) was estimated by the random-effect model. All statistical analyses were performed using comprehensive meta-analysis software. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42023409338). Results: A total of 28 studies (17 cohort studies, 9 cross-sectional studies, and 2 case–control studies) were included. The overall pooled prevalence of depression in ACS, derived from 28 studies, was 28.5% (95% CI: 0.28–0.29, P = .000, I 2 = 99%). 21 included studies showed a prevalence of 20.3% (95% CI: 0.20–0.21, P = .000, I 2 = 96%) in men, and the prevalence in women was 13.6% (95% CI: 0.13–0.14, P = .000, I 2 = 95%). Subgroup analysis showed the lowest prevalence in Europe (20.7%, 95% CI: 0.20–0.22, P = .000, I 2 = 98%); On different diagnostic criteria, the diagnostic and statistical manual of mental disorders (DSM-IV) (36.8%, 95% CI: 0.35–0.38, P = .000, I 2 = 96%) has the highest prevalence. In terms of end year of data collection, the prevalence of ACS depression was lower for studies that ended data collection after 2012 (25.7%, 95% CI: 0.25–0.27, P = .000, I 2 = 99%) than in studies before 2012 (30%, 95% CI: 0.29–0.31, P = .000, I 2 = 98%). Conclusion subsections: This systematic review and meta-analysis suggest high global prevalence of depression among ACS patients, underlining the necessity of more preventive interventions among ACS patients especially in Asian and North American regions.