Tags

Type your tag names separated by a space and hit enter

Meta-analysis of selective serotonin reuptake inhibitors in patients with depression and coronary heart disease.
Am J Cardiol 2011; 107(7):972-9AJ

Abstract

The occurrence of depression in patients with coronary heart disease (CHD) substantially increases the likelihood of a poorer cardiovascular prognosis. Although antidepressants are generally effective in decreasing depression, their use in patients with CHD is controversial. We carried out a meta-analysis to evaluate the health effects of selective serotonin reuptake inhibitors (SSRIs) versus placebo or no antidepressants in patients with CHD and depression. Observational studies and randomized controlled trials (RCTs) were searched in MEDLINE, EMBASE, PsycINFO, Cochrane Controlled Clinical Trial Register and other trial registries, and references of relevant articles. Primary outcomes were readmission for CHD (including myocardial infarction, unstable angina, and stroke) and all-cause mortality; the secondary outcome was severity of depression symptoms. Seven articles on 6 RCTs involving 2,461 participants were included. One study incorrectly randomized participants, and another was a reanalysis of RCT data. These were considered observational and analyzed separately. When only properly randomized trials were considered (n = 734 patients), patients on SSRIs showed no significant differences in mortality (risk ratio 0.39, 95% confidence interval 0.08 to 2.01) or CHD readmission rates (0.74, 0.44 to 1.23) compared to controls. Conversely, when all studies were included, SSRI use was associated with a significant decrease in CHD readmission (0.63, 0.46 to 0.86) and mortality rates (0.56, 0.35 to 0.88). A significantly greater improvement in depression symptoms was always apparent in patients on SSRIs with all selected indicators. In conclusion, in patients with CHD and depression, SSRI medication decreases depression symptoms and may improve CHD prognosis.

Authors+Show Affiliations

Department of Internal Medicine, Aging and Nephrologic Diseases, University of Bologna, Italy. carmine.pizzi@unibo.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

21256471

Citation

Pizzi, Carmine, et al. "Meta-analysis of Selective Serotonin Reuptake Inhibitors in Patients With Depression and Coronary Heart Disease." The American Journal of Cardiology, vol. 107, no. 7, 2011, pp. 972-9.
Pizzi C, Rutjes AW, Costa GM, et al. Meta-analysis of selective serotonin reuptake inhibitors in patients with depression and coronary heart disease. Am J Cardiol. 2011;107(7):972-9.
Pizzi, C., Rutjes, A. W., Costa, G. M., Fontana, F., Mezzetti, A., & Manzoli, L. (2011). Meta-analysis of selective serotonin reuptake inhibitors in patients with depression and coronary heart disease. The American Journal of Cardiology, 107(7), pp. 972-9. doi:10.1016/j.amjcard.2010.11.017.
Pizzi C, et al. Meta-analysis of Selective Serotonin Reuptake Inhibitors in Patients With Depression and Coronary Heart Disease. Am J Cardiol. 2011 Apr 1;107(7):972-9. PubMed PMID: 21256471.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meta-analysis of selective serotonin reuptake inhibitors in patients with depression and coronary heart disease. AU - Pizzi,Carmine, AU - Rutjes,Anne Wilhelmina Saskia, AU - Costa,Grazia Maria, AU - Fontana,Fiorella, AU - Mezzetti,Andrea, AU - Manzoli,Lamberto, Y1 - 2011/01/20/ PY - 2010/09/28/received PY - 2010/11/12/revised PY - 2010/11/12/accepted PY - 2011/1/25/entrez PY - 2011/1/25/pubmed PY - 2011/5/24/medline SP - 972 EP - 9 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 107 IS - 7 N2 - The occurrence of depression in patients with coronary heart disease (CHD) substantially increases the likelihood of a poorer cardiovascular prognosis. Although antidepressants are generally effective in decreasing depression, their use in patients with CHD is controversial. We carried out a meta-analysis to evaluate the health effects of selective serotonin reuptake inhibitors (SSRIs) versus placebo or no antidepressants in patients with CHD and depression. Observational studies and randomized controlled trials (RCTs) were searched in MEDLINE, EMBASE, PsycINFO, Cochrane Controlled Clinical Trial Register and other trial registries, and references of relevant articles. Primary outcomes were readmission for CHD (including myocardial infarction, unstable angina, and stroke) and all-cause mortality; the secondary outcome was severity of depression symptoms. Seven articles on 6 RCTs involving 2,461 participants were included. One study incorrectly randomized participants, and another was a reanalysis of RCT data. These were considered observational and analyzed separately. When only properly randomized trials were considered (n = 734 patients), patients on SSRIs showed no significant differences in mortality (risk ratio 0.39, 95% confidence interval 0.08 to 2.01) or CHD readmission rates (0.74, 0.44 to 1.23) compared to controls. Conversely, when all studies were included, SSRI use was associated with a significant decrease in CHD readmission (0.63, 0.46 to 0.86) and mortality rates (0.56, 0.35 to 0.88). A significantly greater improvement in depression symptoms was always apparent in patients on SSRIs with all selected indicators. In conclusion, in patients with CHD and depression, SSRI medication decreases depression symptoms and may improve CHD prognosis. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/21256471/Meta_analysis_of_selective_serotonin_reuptake_inhibitors_in_patients_with_depression_and_coronary_heart_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(10)02541-5 DB - PRIME DP - Unbound Medicine ER -