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14 TCAs have cardiac toxicity, and SNRIs have complications related to hypertension. 15,16 Patients should be closely observed when they have these prescriptions. There is no evidence that shows that patients with depression have a reduced risk of CHD with the other antidepressants. Thus, clinical doctors have a great interest in finding a treatment not only for treating depression but also for reducing CHD risk. SSRIs have been recommended by the American Heart Association (AHA) for treating CHD patients with depression because of their safety. 17 Although some studies have shown the effectiveness of acupuncture in patients with depression, 18,19 less evidence could be found from long-term follow-up studies to show that patients with depression have CHD protection with acupuncture treatment. The National Health Insurance (NHI) program was established in 1995 in Taiwan by the National Health Insurance Administration.

United statesTaiwanese national health insurance research databaseAmerican heart associationLongitudinal health insurance databaseInternational classification of diseasesResearch ethics committee of china medical universityNational health insuranceNational health insurance administrationR foundation for statistical computingInsurance databaseInternational classificationNinth revisionClinical modificationResearch ethics committeeChina medical universityDisease categories