Key result
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).
Why the study?
Does antidepressant treatment improve long-term depression status and prevent new cardiac events in patients with depression following myocardial infarction?
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.
Answers are grounded in this paper and cite their sources.
Antidepressant treatment did not improve post-MI depression or prognosis; leaves open optimal management strategies in this population.
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.
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Melle et al. (2007) conducted an 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).
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