What question did this study set out to answer?

To determine how frequently major depressive disorder begins prior to acute coronary syndrome and whether onset timing influences clinical response to sertraline.

March 1, 2006Archives of General Psychiatry

Onset of Major Depression Associated With Acute Coronary Syndromes

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Why the study?

Does sertraline improve depression in patients with acute coronary syndrome and major depressive disorder?

Population

369 patients with acute coronary syndrome (ACS) and major depressive disorder (MDD)

Comparison

Sertraline vs Placebo

Design

RCT, randomized, double-blind, placebo-controlled

Authors

AGAlexander H. GlassmanBoston University JBJ. Thomas BiggerElectrophysiology MGMichael GaffneyWashington State University

Discussion

Member takes

Implication

Supports sertraline for pre-ACS MDD onset; extends RCT evidence for targeted antidepressant use in ACS.

Key Points

To determine how frequently major depressive disorder begins prior to acute coronary syndrome and whether onset timing influences clinical response to sertraline.
Randomized, double-blind, placebo-controlled trial across 40 outpatient clinics in 10 countries evaluating 369 patients with acute coronary syndrome and major depressive disorder between April 1, 1997, and April 30, 2001.
Depressive episode timing and diagnosis were determined using the Diagnostic Interview Schedule, with clinical response assessed via the Clinical Global Impression-Improvement scale.
Fifty-three percent of depressive episodes began prior to index hospitalization (197 of 369 patients), with 94% of those starting more than 30 days before acute coronary syndrome.
Patients with depression onset before acute coronary syndrome responded significantly more often to sertraline than placebo (63% vs 46%; odds ratio, 2.0; 95% confidence interval, 1.13-3.55), whereas post-hospitalization onset showed a high placebo response rate (69% vs 60%; response ratio, 1.15).
Multivariate analysis showed that timing of current episode onset, prior history of depression, and baseline severity independently predicted the sertraline-to-placebo response ratio.

Structured PICO

Does sertraline improve depression in patients with acute coronary syndrome and major depressive disorder?

Population

369 patients with acute coronary syndrome (ACS) and major depressive disorder (MDD)

Intervention

Sertraline

Comparator

Placebo

Outcome

Treatment response measured with the Clinical Global Impression-Improvement scalepatient reported

Sertraline provides significant benefit for major depressive disorder in ACS patients, particularly when the depressive episode began prior to the ACS event or is severe.

Cite This Study

Glassman et al. (2006) studied this question.

synapsesocial.com/papers/6a703d5226a7f98052dcbe0a https://doi.org/10.1001/archpsyc.63.3.283

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Onset of Major Depression Associated With Acute Coronary Syndromes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Onset of Major Depression Associated With Acute Coronary Syndromes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider