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To the Editor: Dr Ruo and colleagues¹ found that patients with coronary artery disease (CAD) and depression had a lower health-related quality of life (HRQOL), as measured by the Seattle Angina Questionnaire, than did patients with coronary disease but without depression. In contrast, among patients with CAD, reduced cardiac function was not associated with diminished HRQOL.

The finding that depression is associated with lower HRQOL is hardly surprising: depression consists of symptoms that reduce HRQOL. Furthermore, the question of whether cardiac function is related to current HRQOL is irrelevant. Rather, cardiac function is important because it predicts future events and thus future HRQOL and life expectancy. Thus, the findings of this study do not change the recommendation that depression should be identified and treated in patients with CAD.² At best, the study provides additional evidence that among patients with CAD, their questionnaire captures important components of HRQOL and thus has . . . [Full Text of this Article]

Afschin Gandjour, MD, PhD
Institute of Health Economics and Clinical Epidemiology
University of Cologne
Cologne, Germany

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