Key result
Antidepressant therapy in patients following acute coronary syndrome had no effect on all-cause mortality (OR 0.97; 95% CrI 0.66-1.42) but reduced repeat hospitalizations.
Why the study?
The study was conducted to investigate the effect of antidepressant therapy on mortality and cardiovascular outcomes in patients with acute coronary syndrome.
Does antidepressant therapy reduce mortality and cardiovascular outcomes in patients following acute coronary syndrome?
Meta-Analysis (n=1,935)
Does antidepressant therapy reduce mortality and cardiovascular outcomes in patients following acute coronary syndrome?
Odds Ratio: 0.97 (95% CI 0.66–1.42)
Antidepressant therapy in post-ACS patients does not affect mortality but may reduce repeat hospitalizations and recurrent MI in those with depression.
No mortality benefit post-ACS cautions against prognostic expectations; extends support for reduced hospitalizations.
AIMS: The aim of this study is to investigate the effect of antidepressant therapy on mortality and cardiovascular outcomes in patients with acute coronary syndrome (ACS). METHODS AND RESULTS: We systematically searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials and performed a Bayesian random-effects meta-analysis of randomized controlled trials that investigated antidepressant pharmacotherapy in patients following ACS. The primary outcome was all-cause mortality. Secondary outcomes were repeat hospitalizations and recurrent myocardial infarctions (MIs). Ten randomized controlled trials with a total of 1935 patients qualified for inclusion. Selective serotonin reuptake inhibitors were investigated in six, bupropion in three, and mirtazapine in one trial. Placebo was used as control in eight trials. There was no difference in all-cause mortality [odds ratio (OR) 0.97, 95% credible interval (CrI) 0.66-1.42] and recurrent MI (OR 0.64, 95% CrI 0.40-1.02) between patients receiving antidepressants compared with controls, whereas antidepressant therapy was associated with less repeat hospitalizations (OR 0.62, 95% CrI 0.40-0.94). In patients with ACS and concomitant depression, antidepressants reduced the odds of recurrent MI compared with usual care/placebo (OR 0.45, 95% CrI 0.25-0.81). Extended funnel plots suggest robustness of the observations. CONCLUSIONS: Antidepressants in patients following ACS have no effect on mortality but reduce repeat hospitalizations; in patients with depression, there is a reduced risk of recurrent MI with antidepressant therapy.
No takes yet. Share an insight, caveat, or question.
Sweda et al. (2020) conducted a meta-analysis in acute coronary syndrome (ACS) (n=1,935). Antidepressant therapy vs. Placebo or usual care was evaluated on all-cause mortality (OR 0.97, 95% CI 0.66-1.42). Antidepressant therapy in patients following acute coronary syndrome had no effect on all-cause mortality (OR 0.97; 95% CrI 0.66-1.42) but reduced repeat hospitalizations.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: