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In Reply: Dr Ziegelstein raises the issue of the representativeness of the CREATE study population and cites statistics for the mean age at time of first myocardial infarction in US patients to support his argument. The CREATE sample was not restricted to patients with a history of myocardial infarction. It also included patients who had angioplasty, coronary artery bypass graft surgery, or cardiac catheterization results showing a greater than 50% blockage in at least 1 major coronary artery. All CREATE patients were seeking outpatient treatment for major depression. Although it has been reported that elderly patients are underrepresented in trials of acute coronary syndromes,¹ there were no age limits on the CREATE sample. It has also been suggested that elderly individuals are less likely to seek treatment for major depression than younger patients.² While we agree that age may be an important variable in considering lack of treatment response and . . . [Full Text of this Article]

François Lespérance, MD
francois.lesperance@umontreal.ca

Nancy Frasure-Smith, PhD
McGill University
Montreal, Quebec
For the CREATE Investigators

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Effects of Citalopram and Interpersonal Psychotherapy on Depression in Patients With Coronary Artery Disease: The Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) Trial
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