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July 8, 1992

Social and Economic Factors in Patients With Coronary Disease

Author Affiliations

Maryland Psychiatric Research Center Baltimore

JAMA. 1992;268(2):196. doi:10.1001/jama.1992.03490020039015

To the Editor.  The JOURNAL recently published two articles and an Editorial on the influence of social and economic factors on mortality following coronary artery disease.1-3 Psychosocial effects on mortality following vascular disease affecting another end organ, the brain, have been studied by our group in recent years. Our findings are of relevance to the observations published in THE JOURNAL.In an initial study of 88 Australian stroke patients followed up for 15 months, we found that depressed patients had a sevenfold higher risk of death than nondepressed patients (odds ratio, 7.9; 95% confidence interval, 1.2 to 53.2).4 In a second series of 91 patients in Baltimore, Md, followed up for 10 years, we found that initially depressed patients had nearly three-and-a-half times the risk of death than nondepressed patients (odds ratio, 3.4; 95% confidence interval, 1.4 to 8.2). This finding held true even when other risk