Selective serotonin re-uptake inhibitors for the treatment of depression in coronary artery disease and chronic heart failure: evidence for pleiotropic effects.
Depression is a common co-morbidity in patients with cardiovascular diseases such as chronic coronary artery disease, acute coronary syndromes, post by-pass surgery and chronic heart failure. There is a significant body of evidence suggesting that the presence of depression is independently associated with a decline in health status and an increase in the risk of hospitalization and death for patients with coronary artery disease or congestive heart failure. Novel treatment modalities such as selective serotonin re-uptake inhibitors (SSRIs) may improve depressive symptoms and prognosis of post-myocardial infarction and heart failure patients interacting with the common pathophysiologic mechanisms of depression and cardiovascular disease. This review summarizes current experimental and clinical evidence regarding the pleiotropic effects of SSRIs on platelet functions, immune and neurohormonal activation, and cardiac rhythm disturbances in patients with cardiovascular disease. These bio-modulatory properties of SSRIs may be translated into improvement of patient clinical outcomes beyond their anti-depressant action.
Paraskevaidis
Ioannis
I
Second Department of Cardiology and Heart Failure Clinic, University of Athens, Greece. elbee@ath.forthnet.gr
Parissis
John T
JT
Fountoulaki
Katerina
K
Filippatos
Gerasimos
G
Kremastinos
Dimitrios
D
D001792:Blood Platelets / Q000187:drug effects; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000494:pharmacology*
D017367:Selective Serotonin Reuptake Inhibitors