Effects of antidepressant treatment following myocardial infarction.
BACKGROUND
Depression following myocardial infarction is associated with poor cardiac prognosis. It is unclear whether antidepressant treatment improves long-term depression status and cardiac prognosis.


OBJECTIVE
To evaluate the effects of antidepressant treatment compared with usual care in an effectiveness study.


METHODS
In a multicentre randomised controlled trial, 2177 myocardial infarction patients were evaluated for ICD-10 depression and randomised to intervention (n=209) or care as usual (n=122). Both arms were evaluated at 18 months post-myocardial infarction for long-term depression status and new cardiac events.


RESULTS
No differences were observed between intervention and control groups in mean scores on the Beck Depression Inventory (11.0, s.d.=7.5 v.10.2, s.d.=5.1, P=0.45) or presence of ICD-10 depression (30.5 v. 32.1%, P=0.68). The cardiac event rate was 14% among the intervention group and 13% among controls (OR=1.07, 95% CI 0.57-2.00).


CONCLUSIONS
Antidepressant treatment did not alter long-term depression post-myocardial infarction status or improve cardiac prognosis.
van Melle
Joost P
JP
Department of Cardiology, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, The Netherlands.
de Jonge
Peter
P
Honig
Adriaan
A
Schene
Aart H
AH
Kuyper
Astrid M G
AM
Crijns
Harry J G M
HJ
Schins
Annique
A
Tulner
Dorien
D
van den Berg
Maarten P
MP
Ormel
Johan
J
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology*; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011788:Quality of Life; D012306:Risk; D016896:Treatment Outcome
D000928:Antidepressive Agents