Cardiac Markers in Depressed Patients With Coronary Heart Disease - R01HL147862

Inclusion Criteria: * Patients seen at the Washington University Medical Center with coronary heart disease (CHD) documented by coronary angiography or history of acute coronary syndrome (ACS). * On a stable medication regimen (only minor changes in drug or dosage in last 30 days) are eligible for recruitment. * Meet the diagnostic criteria for a depressive disorder, score ≥ 14 on the Beck Depression Inventory (BDI-II), and not meet any exclusion criteria. Exclusion Criteria: * Thyroid disease or thyroid medications. * Moderate to severe cognitive impairment. * Major psychiatric comorbidities. * Taking antidepressants other than a selective serotonin reuptake inhibitor (SSRI). * Suicidal features. * Current substance abuse. * New York Heart Association (NYHA) class III or higher or a recent (\<3 months) acute coronary syndrome (ACS), coronary artery bypass graft surgery, cardiac hospitalization, or cardiac-related emergency department visit. * Advanced malignancy, a disability that would prevent compliance with the study protocol, or physician or patient refusal.