Objectives Despite previous researches has demonstrated an association between depression and both of abnormal cardiac electrophysiology and sudden cardiac death (SCD), its relationship with ventricular arrhythmias in patients with cardiovascular diseases (CVD) is inconsistent and less well evaluated. The purpose of this study was to assess those associations by meta-analysis.
Methods MEDLINE, Elsevier and PsycINFO databases (January 1990–January 2013) were searched as data sources. Studies were included if they considered aspects of depression in the CVD patients; were prospective or case-controlled study; evaluated the risk of depression on ventricular arrhythmias. Two authors independently reviewed each potential study for eligibility, assessed methodologic quality, and extracted the data. We used a random-effect (RE) model to calculate the combined hazard ratio (HR) and 95% confidence interval (CI). Meta regression and subgroup analyses were performed to identify the source of heterogeneity.
Results Seven studies met our selection criteria were integrated using meta-analysis (n = 3261). The RE pooled HR of 1.48 (95% CI: 1.05–2.10, p = 0.25) for depression increased the risk of ventricular arrhythmias for CVD patients. Heterogeneity was found among and within studies (Q = 20.94, p = 0.002). Metaregression showed that the effect size is negatively correlated with the type of study design and the year of publication. Subgroup analysis indicated a significant correlation between depression and ventricular arrhythmias in CHD patients (HR: 1.77, 95% CI: 1.19-2.62, p = 0.005), but not in ICD patients (HR: 1.18, 95% CI: 0.73-1.91, p = 0.487). The trends were similar in different type of study subgroup (retrospective study and prospective study), were opposite in two year of publication subgroup (1993–2009 and 2011–2012). The heterogeneity were reduced in these subgroups
Conclusions This meta-analysis suggests that depression is associated with a 48% increased risk of ventricular arrhythmias in patients with CVD. Future research should find a safe and effective method of preventing depression for CVD patients.