Increased subsequent risk of acute coronary syndrome for patients with depressive disorder: A nationwide population-based retrospective cohort study

Aim The purpose of this study was to explore the possible association between subsequent acute coronary syndrome (ACS) risk and depressive disorder. Methods We used data from the National Health Insurance system of Taiwan to address the research topic. The exposure cohort contained 10 871 patients with new diagnoses of depressive disorders. Each patient was randomly frequency-matched for sex and age with four participants from the general population who did not have any ACS history before the index date (control group). Cox's proportion hazard regression analyses were conducted to estimate the relation between depressive disorders and subsequent ACS risk. Results Among patients with depressive disorders, the overall risk for developing subsequent ACS was significantly higher than that of the control group (adjusted hazard ratio: 1.88, 95% confidence interval: 1.63-2.17). Further analysis revealed that the higher risk was observed in patients who were male, were of older age, or whose diagnosis was combined with other comorbidities. Conclusions The findings from this population-based retrospective cohort study suggest that depressive disorder is associated with an increased subsequent ACS risk.