Antidepressant treatment did not significantly reduce the incidence of cardiac events compared to usual care in patients with depression following myocardial infarction (14% vs 13%, OR 1.07).
RCT (n=331)
Open-label (Zelen design)
Computer-generated permuted blocks of four, stratified
Yes
Does antidepressant treatment improve long-term depression status and prevent new cardiac events in patients with depression following myocardial infarction?
Antidepressant treatment for post-MI depression did not improve depression scores or reduce subsequent cardiac events compared to usual care.
Odds Ratio: 1.07 (95% CI 0.57–2)
Absolute Event Rate: 14% vs 13%
p-value: p=0.76
BACKGROUND: Depression following myocardial infarction is associated with poor cardiac prognosis. It is unclear whether antidepressant treatment improves long-term depression status and cardiac prognosis. AIMS: To evaluate the effects of antidepressant treatment compared with usual care in an effectiveness study. METHOD: In a multicentre randomised controlled trial, 2177 myocardial infarction patients were evaluated for ICD-10 depression and randomised to intervention (n=209) or care as usual (n=122). Both arms were evaluated at 18 months post-myocardial infarction for long-term depression status and new cardiac events. RESULTS: No differences were observed between intervention and control groups in mean scores on the Beck Depression Inventory (11.0, s.d.=7.5 v.10.2, s.d.=5.1, P=0.45) or presence of ICD-10 depression (30.5 v. 32.1%, P=0.68). The cardiac event rate was 14% among the intervention group and 13% among controls (OR=1.07, 95% CI 0.57-2.00). CONCLUSIONS: Antidepressant treatment did not alter long-term depression post-myocardial infarction status or improve cardiac prognosis.
Melle et al. (Thu,) conducted a rct in Depression following myocardial infarction (n=331). Antidepressant treatment (mirtazapine, citalopram, or tailored treatment) vs. Care as usual was evaluated on Cardiac events (cardiac death or hospital admission for documented non-fatal myocardial infarction, myocardial ischaemia, coronary revascularisation, heart failure or ventricular tachycardia) (OR 1.07, 95% CI 0.57-2.00, p=0.76). Antidepressant treatment did not significantly reduce the incidence of cardiac events compared to usual care in patients with depression following myocardial infarction (14% vs 13%, OR 1.07).