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Depression is common after acute coronary syndrome (ACS), adversely affecting cardiac course and prognosis. There have been only afew evidence-based treatment options for depression in ACS. Accordingly, we planned the Korean Depression in ACS (K-DEPACS)study, which investigated depressive disorders in patients with ACS using a naturalistic prospective design, and the Escitalopram for DEPACS(EsDEPACS) trial, which assessed the efficacy and safety of escitalopram for treating major or minor depression in patients withACS. Participants in the K-DEPACS study were consecutively recruited from patients with ACS who were recently hospitalized at ChonnamNational University Hospital, Gwangju, South Korea. Diagnoses were confirmed by coronary angiography from 2005. Data on depressiveand cardiovascular characteristics were obtained at 2 weeks, 3 months, 12 months, and every 6 months thereafter following theindex ACS admission. The K-DEPACS participants who met the DSM-IV criteria for major or minor depressive disorder were randomlyassigned to groups in the 24-week, double-blind, placebo-controlled EsDEPACS trial beginning in 2007. The outcome of treatments fordepressive and other psychiatric symptoms, issues related to safety, including general adversity, and cardiovascular factors were assessed. The K-DEPACS study can significantly contribute to research on the complex relationships between depression and ACS. The results ofthe EsDEPACS trial provide an additional treatment option for clinicians treating these patients.

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