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Depression treatment after myocardial infarction and long-term risk of subsequent cardiovascular events and

Marij Zuidersma1, Henk Jan Conradi, Joost P van Melle

  • 1Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands. m.zuidersma@umcg.nl

Journal of Psychosomatic Research
|January 1, 2013
PubMed

Insights

Implementing an antidepressant strategy for depressed myocardial infarction patients did not improve cardiovascular outcomes or reduce mortality. However, receiving depression treatment was linked to increased survival rates.

Area of Science:

  • Cardiology
  • Psychiatry
  • Clinical Research

Background:

  • Depression is common after myocardial infarction (MI) and may negatively impact cardiovascular outcomes.
  • Effective treatment strategies for post-MI depression are crucial for patient prognosis.

Purpose of the Study:

  • To evaluate the long-term effects of an antidepressant treatment strategy on cardiovascular outcomes and mortality in depressed MI patients.
  • To compare outcomes between an intervention group receiving depression treatment options and a control group receiving usual care.

Main Methods:

  • 331 depressed MI patients were randomized to an intervention group (offered antidepressant treatments) or usual care.
  • Patients were monitored for depression at multiple time points post-MI.
  • The primary outcome was a composite of cardiovascular events and cardiac mortality over 8 years; all-cause mortality was a secondary outcome.

Main Results:

  • The implemented antidepressant strategy did not significantly reduce the risk of the primary composite outcome (cardiovascular events/cardiac mortality) or all-cause mortality.
  • Patients who received depression treatment, irrespective of randomization, showed significantly reduced all-cause mortality compared to those who did not.

Conclusions:

  • An antidepressant treatment strategy did not improve cardiovascular morbidity or mortality in depressed MI patients compared to usual care.
  • Receiving depression treatment was associated with increased survival, though the direct causality versus confounding factors remains uncertain.
Abstract

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